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MRS. CHRISTINE L WIEDEMANN

Optician >> Technician/Technologist >> Eye and Vision Services Providers

Registrant NPI Number: 1356462766

Individual Registrant:
MRS. CHRISTINE L WIEDEMANN 
Gender: F
Not Sole Proprietor

Location and contact information for practice:
12 MARTIN STREET  WELLSVILLE, UT 14895-1057 US
Tel: 585-593-6041  Fax: --

Contact information for business:
12 MARTIN STREET  WELLSVILLE, UT 14895-1057 US
Tel: 585-593-6041  Fax: --

Registration Information:
NPI: 1356462766
Entity Type: Individual

Specialty information:

PrimaryCodeCategory/DescriptionStateLicense Number
Y156FX1800XEye and Vision Services Providers
Technician/Technologist
Optician
NY007696

Legacy codes, insurance codes and state license numbers:

IssuerNumberStateType




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