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MRS. CHRISTINE L WIEDEMANN
Optician >> Technician/Technologist >> Eye and Vision Services ProvidersRegistrant NPI Number: 1356462766
Individual Registrant:MRS. CHRISTINE L WIEDEMANN
Gender: F
Not Sole Proprietor
Gender: F
Not Sole Proprietor
Location and contact information for practice:
12 MARTIN STREET WELLSVILLE, UT 14895-1057 US
Tel: 585-593-6041 Fax: --
Tel: 585-593-6041 Fax: --
Contact information for business:
12 MARTIN STREET WELLSVILLE, UT 14895-1057 US
Tel: 585-593-6041 Fax: --
Tel: 585-593-6041 Fax: --
Registration Information:
NPI: 1356462766
Entity Type: Individual
Entity Type: Individual
Specialty information:
| Primary | Code | Category/Description | State | License Number |
|---|---|---|---|---|
| Y | 156FX1800X | Eye and Vision Services Providers Technician/Technologist Optician | NY | 007696 |
Legacy codes, insurance codes and state license numbers:
| Issuer | Number | State | Type |
|---|---|---|---|
