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Individual

MRS. LEELEE MUESEBECK

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
OPTICIAN

Contact information

Practice address
100 MAIN ST, BROCKPORT, NY 14420
(585) 637-0430
(585) 637-8016
Mailing address
100 MAIN ST, BROCKPORT, NY 14420
(585) 637-0430
(585) 637-8016

Taxonomy

Speciality
Code
Description
License number
State
156FX1800X
Optician
Primary
37241
NY

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
103285CT
PREFERRED CARE
NY
01
8749
BCBS
NY
Enumeration date
11/09/2006
Last updated
07/08/2007
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