Provider First Line Business Practice Location Address:
500 ERIE STREET SOUTH
Provider Second Line Business Practice Location Address:
LAKE PLAINS EYE CENTER
Provider Business Practice Location Address City Name:
MEDINA
Provider Business Practice Location Address State Name:
NY
Provider Business Practice Location Address Postal Code:
14103
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
585-798-2020
Provider Business Practice Location Address Fax Number:
585-798-3365
Provider Enumeration Date:
03/15/2006