Organization
EAST AVENUE VISION CENTER
Active
Organization subpart
No
Provider details
NPI number
Authorized official
KIM HESCHKE (OFFICE)
(716) 434-2874
Entity
Organization
Contact information
Practice address
215 EAST AVE, LOCKPORT, NY 14094-3812
(716) 434-2874
Mailing address
215 EAST AVE, LOCKPORT, NY 14094-3812
(716) 434-2874
Taxonomy
Speciality
Code
Description
License number
State
302F00000X
Exclusive Provider Organization
Primary
003342
NY
Other
Enumeration date
05/20/2011
Last updated
05/20/2011
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