Individual
MRS. STACEY LORRAINE NUTTING
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
OPHTHALMIC DISPENSER
Contact information
Practice address
5792 WIDEWATERS PKWY STE 101, SYRACUSE, NY 13214-1847
(315) 422-4412
(315) 373-0164
Mailing address
5792 WIDEWATERS PKWY STE 101, SYRACUSE, NY 13214-1847
(315) 422-4412
(315) 373-0164
Taxonomy
Speciality
Code
Description
License number
State
156FX1800X
Optician
Primary
008389-1
NY
Other
Enumeration date
06/19/2019
Last updated
06/19/2019
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