Individual
MARK NELSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
OD
Contact information
Practice address
289 GENESEE ST, UTICA, NY 13501-3823
(315) 732-1151
Mailing address
289 GENESEE ST, UTICA, NY 13501-3823
Taxonomy
Speciality
Code
Description
License number
State
152W00000X
Optometrist
Primary
TUV008843
NY
Other
Enumeration date
07/23/2018
Last updated
07/23/2018
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