National Provider Identifier

Exodus Vision, LLC

Exodus Vision, LLC is listed in the NPPES registry with a primary specialty of Eyewear Supplier in Rochester, NY and a listed phone number of (585) 254-0022.

NPI 1245504471Rochester, NYEyewear Supplier

Profile Overview

NPI
1245504471
Provider Type
Organization
Primary Specialty
Eyewear Supplier
Enumeration Date
March 06, 2012
Last Updated
June 01, 2012

Practice Location

  • 1260 Lyell Ave
  • Rochester, NY 14606-2040

Phone: (585) 254-0022

Mailing Address

  • 2580 Anthem Village Dr
  • Henderson, NV 89052-5503

Specialties

  • Eyewear Supplier (332H00000X)
Full Record
NPI
1245504471
Entity Type
Organization
EIN
<UNAVAIL>
Organization Name
Exodus Vision, LLC
Other Organization Name
<Unavail>
Provider Other Organization Name Type Code
6
Mailing Street Address
2580 Anthem Village Dr
Mailing City
Henderson
Mailing State
NV
Mailing ZIP Code
89052-5503
Mailing Country
US
Mailing Phone
(585) 254-0022
Practice Street Address
1260 Lyell Ave
Practice City
Rochester
Practice State
NY
Practice ZIP Code
14606-2040
Practice Country
US
Practice Phone
(585) 254-0022
Enumeration Date
March 06, 2012
Last Updated
June 01, 2012
Authorized Official Last Name
Liechty
Authorized Official First Name
Erica
Authorized Official Middle Name
Marie
Authorized Official Title
Admin Manager
Authorized Official Phone
(574) 935-9827
Organization Subpart
No
updated_by_file
npidata_pfile_20050523-20260308.csv
Taxonomies
Eyewear Supplier (332H00000X)