Provider First Line Business Practice Location Address:
83 16 NOTHERN BLVD
Provider Second Line Business Practice Location Address:
LAXMI AMERICAN OPTICAL
Provider Business Practice Location Address City Name:
JACKSON HEIGHTS
Provider Business Practice Location Address State Name:
NY
Provider Business Practice Location Address Postal Code:
11372
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
718-335-2240
Provider Business Practice Location Address Fax Number:
718-335-2241
Provider Enumeration Date:
10/31/2006