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SPENCER LACY FAIRGRIEVE

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
OD

Contact information

Practice address
33 W 42ND ST, NEW YORK, NY 10036-8005
(212) 938-4000
Mailing address
19255 CONDOR WAY, COTTONWOOD, CA 96022-8817
(530) 526-2332

Taxonomy

Speciality
Code
Description
License number
State
152W00000X
Optometrist
009641
NY
152W00000X
Optometrist
Primary
TUV009641
NY
390200000X
Student in an Organized Health Care Education/Training Program

Other

Enumeration date
06/16/2022
Last updated
08/14/2022
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