Healthcare Provider Details

I. General information

NPI: 1225136245
Provider Name (Legal Business Name): LAURA C WALSH OD
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 09/21/2006
Last Update Date: 08/17/2026
Certification Date: 08/17/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2395 YORK RD STE 12
JAMISON PA
18929-1071
US

IV. Provider business mailing address

2395 YORK RD STE 12
JAMISON PA
18929-1071
US

V. Phone/Fax

Practice location:
  • Phone: 215-491-2020
  • Fax: 267-483-8779
Mailing address:
  • Phone: 215-491-2020
  • Fax: 267-483-8779

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code152W00000X
TaxonomyOptometrist
License NumberOEG001791
License Number StatePA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: