Individual
MRS. YVONNE MACINTOSH
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
OPTICIAN
Contact information
Practice address
2909 E HATCH RD, MODESTO, CA 95351-4921
(209) 552-6754
(209) 537-4802
Mailing address
2909 E HATCH RD, MODESTO, CA 95351-4921
(209) 552-6754
(209) 537-4802
Taxonomy
Speciality
Code
Description
License number
State
156FX1800X
Optician
Primary
SL1455
CA
Other
Enumeration date
10/05/2010
Last updated
10/05/2010
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