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Organization

FAMILY VISION CLINIC, PC

Active
Organization subpart
No

Provider details

NPI number
Authorized official
RICHARD P CANESTRINI O.D. (PRESIDENT)
(307) 382-3937
Entity
Organization

Contact information

Practice address
544 BROADWAY ST, ROCK SPRINGS, WY 82901-6346
(307) 382-3937
(307) 382-2918
Mailing address
544 BROADWAY ST, ROCK SPRINGS, WY 82901-6346
(307) 382-3937
(307) 382-2918

Taxonomy

Speciality
Code
Description
License number
State
152W00000X
Optometrist
Primary

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
11470300
WY
Enumeration date
09/29/2005
Last updated
08/06/2008
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