Individual
KEITH EDWIN OETINGER
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
OPTICIAN
Contact information
Practice address
24 WEST AVE, SPENCERPORT, NY 14559-1344
(585) 352-1960
(585) 349-7076
Mailing address
24 WEST AVE, SPENCERPORT, NY 14559-1344
(585) 352-1960
(585) 349-7076
Taxonomy
Speciality
Code
Description
License number
State
156FX1800X
Optician
Primary
CO03541
NY
Other
Enumeration date
10/10/2006
Last updated
07/08/2007
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