MEDICARE: ALETHEA L. WESSNER

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	332H00000X	Eyewear Supplier	OEG000477	PA

General Provider Information

NPI Number	:	1982881132
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	ALETHEA L. WESSNER

Provider Business Mailing Address
First Line	:	231 S TULPEHOCKEN ST
Second Line	:
City	:	PINE GROVE
State	:	PA
Zip	:	17963-1037
Country	:	US
Telephone Number	:	570-345-0188
Fax Number	:	570-345-0267

Provider Business Practice Location Address
First Line	:	231 S TULPEHOCKEN ST
Second Line	:
City	:	PINE GROVE
State	:	PA
Zip	:	17963-1037
Country	:	US
Telephone Number	:	570-345-0188
Fax Number	:	570-345-0267

Authorized Official
Title or Position	:	OPTOMETRIST
Name	:	ALETHEA LENORE WESSNER
Credential	:	OD
Telephone Number	:	570-345-0188

Provider Enumeration Date	:	01/29/2008
Last Update Date	:	02/01/2008

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