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General NPI Number Information
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NPI Number | 1548746720
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Entity Type | Individual
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Provider Name | SHELBY ROCKWELL OD
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Gender | Female
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Dates
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Enumeration Date | 07/11/2018
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Last Update Date | 07/11/2018
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Provider Practice Location Address
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Address Line | 6500 PORTER RD STE 2020
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City | NIAGARA FALLS
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State | NY
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Zip | 14304-1529
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Country | US
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Telephone | 716-282-1114
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Fax | 716-282-0523
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Provider Business Mailing Address
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Address Line | 6500 PORTER RD STE 2020
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City | NIAGARA FALLS
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State | NY
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Zip | 14304-1529
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Country | US
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Telephone | 716-282-1114
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Fax | 716-282-0523
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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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 | TUV008833-1
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License Number State | NY
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