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General NPI Number Information
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NPI Number | 1861678112
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Entity Type | Organization
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Legal Business Name | JOHN O. EVANS, O.D,
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Dates
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Enumeration Date | 01/17/2008
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Last Update Date | 01/17/2008
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Provider Practice Location Address
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Address Line | 3200 WEST ST
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City | CANANDAIGUA
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State | NY
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Zip | 14424-1722
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Country | US
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Telephone | 585-394-1358
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Fax | 585-394-0261
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Provider Business Mailing Address
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Address Line | 3200 WEST ST
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City | CANANDAIGUA
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State | NY
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Zip | 14424-1722
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Country | US
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Telephone | 585-394-1358
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Fax |
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Authorized Official
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Title or Position | OWNER
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Name | DR. JOHN O. EVANS
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Credential | O.D.
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Telephone | 585-394-1358
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 332H00000X
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Taxonomy Name | Eyewear Supplier
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License Number | TUV003346-1
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License Number State | NY
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