Organization
OPTIVISION
Active
Organization
OPTIVISION
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. KENNETH W MCNEIL (OPTICIAN,OWNER)
(607) 753-7514
Entity
Organization
Contact information
Practice address
3662 THE PARK, CORTLAND, NY 13045-3324
(607) 753-7514
(607) 753-7515
Mailing address
3662 THE PARK, CORTLAND, NY 13045-3324
(607) 753-7514
(607) 753-7515
Taxonomy
Speciality
Code
Description
License number
State
152W00000X
Optometrist
TUV005032
NY
156FX1800X
Optician
4079
NY
332H00000X
Eyewear Supplier
Primary
4079
NY
332H00000X
Eyewear Supplier
TUV005032
NY
Other
Enumeration date
05/18/2007
Last updated
09/16/2009
Update your record
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