Individual
SHANICE KING
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
1220 PENINSULA BLVD, HEWLETT, NY 11557-1200
(516) 881-3484
Mailing address
11605 N LAMAR BLVD, AUSTIN, TX 78753-2658
(737) 222-6996
(512) 522-8836
Taxonomy
Speciality
Code
Description
License number
State
156FX1800X
Optician
Primary
009748
NY
Other
Enumeration date
07/29/2019
Last updated
07/29/2019
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