Sidet Sou, Od, LLC

NPI #1336301597 in Manchester, Connecticut

Provider Information

NPI Number: 1336301597
Entity Type: Organization
Organization Name: Sidet Sou, Od, LLC
Primary Specialty: Optometrist
Enumeration Date: Jun 30, 2008
Last Updated: Sep 6, 2023

Practice Location

Address: 69 PAVILION DR
City: Manchester
State: Connecticut
ZIP Code: 06042-8702
Phone: (860) 644-9439

Authorized Official

Name: DR. SIDET SOU, O.D.
Title: OPTOMETRIST
Phone: (860) 644-9439

Specialties & Taxonomy Codes

Specialty	Taxonomy Code	Primary
Optometrist	152W00000X	Primary

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