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General NPI Number Information
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NPI Number | 1477610301
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Entity Type | Organization
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Legal Business Name | PRESTON LOWE APPLE OPTICAL
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Dates
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Enumeration Date | 01/02/2007
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Last Update Date | 07/26/2013
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Provider Practice Location Address
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Address Line | 1622 STATE ST
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City | WATERTOWN
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State | NY
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Zip | 13601-3520
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Country | US
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Telephone | 315-788-1515
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Fax | 315-779-9577
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Provider Business Mailing Address
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Address Line | 1622 STATE ST
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City | WATERTOWN
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State | NY
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Zip | 13601-3520
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Country | US
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Telephone | 315-788-1515
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Fax | 315-779-9577
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Authorized Official
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Title or Position | BOOKKEEPER
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Name | SUSAN LOWE
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Credential |
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Telephone | 315-686-3140
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 152W00000X
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Taxonomy Name | Optometrist
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License Number | 003656
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License Number State | NY
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