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Organization

BRIAN MAILLARD, OD

Active
Organization subpart
No

Provider details

NPI number
Authorized official
DR. BRIAN MAILLARD OD (OWNER)
(518) 234-2931
Entity
Organization

Contact information

Practice address
108 LEGION DR, COBLESKILL, NY 12043-5112
(518) 234-2931
(518) 234-0140
Mailing address
108 LEGION DR, COBLESKILL, NY 12043-5112
(518) 234-2931
(518) 234-0140

Taxonomy

Speciality
Code
Description
License number
State
332H00000X
Eyewear Supplier
Primary
TUV006803
NY

Other

Enumeration date
10/06/2011
Last updated
10/06/2011
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