Individual
JUSTIN ROBERT EDWARDS
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
OPTICIAN
Contact information
Practice address
5399 W GENESEE ST, CAMILLUS, NY 13031-2265
(315) 468-2745
(315) 468-2786
Mailing address
5399 W GENESEE ST, CAMILLUS, NY 13031-2265
(315) 468-2745
(315) 468-2786
Taxonomy
Speciality
Code
Description
License number
State
156FX1800X
Optician
Primary
C009325
NY
Other
Enumeration date
11/12/2018
Last updated
11/12/2018
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