Individual
BRENNAN WELLS
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
LICENSED OPTICIAN
Contact information
Practice address
341 STATE ROUTE 104, OSWEGO, NY 13126-2911
(315) 207-7044
(315) 343-5165
Mailing address
341 STATE ROUTE 104, OSWEGO, NY 13126-2911
(315) 207-7044
(315) 343-5165
Taxonomy
Speciality
Code
Description
License number
State
156FX1800X
Optician
Primary
9584268
NY
Other
Enumeration date
12/18/2017
Last updated
12/18/2017
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