Individual
AMY STJOHN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LICENSED OPTICIAN
Contact information
Practice address
101 1/2 EAST ST, FORT EDWARD, NY 12828-1813
(518) 232-7420
Mailing address
101 1/2 EAST ST, FORT EDWARD, NY 12828-1813
(518) 232-7420
Taxonomy
Speciality
Code
Description
License number
State
156FX1800X
Optician
Primary
008825
NY
Other
Enumeration date
10/31/2018
Last updated
10/31/2018
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