Individual
MR. RUSSELL JOHN AVERY SR.
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
LICENSED OPTICIAN
Contact information
Practice address
KNAUF OPTICAL, 235 VESTAL AVE., ENDICOTT, NY 13760
(607) 748-0765
(607) 748-0765
Mailing address
2209 GLENWOOD RD, VESTAL, NY 13850-5715
(607) 748-5463
Taxonomy
Speciality
Code
Description
License number
State
156FX1800X
Optician
Primary
6965
NY
Other
Enumeration date
01/29/2007
Last updated
07/09/2007
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