Individual
THERESA MARIE LEGAULT
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
OPTICIAN
Contact information
Practice address
7494 US HIGHWAY 11, POTSDAM, NY 13676-3577
(315) 268-3921
(315) 268-6923
Mailing address
7494 US HIGHWAY 11, POTSDAM, NY 13676-3577
(315) 268-6921
(315) 268-6923
Taxonomy
Speciality
Code
Description
License number
State
156FX1800X
Optician
Primary
6845
NY
156FX1800X
Optician
C006845-01
NY
Other
Enumeration date
10/10/2024
Last updated
10/10/2024
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