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General NPI Number Information
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NPI Number | 1033111877
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Entity Type | Organization
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Legal Business Name | THE BRANDE SAAD GROUP
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Dates
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Enumeration Date | 08/11/2005
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Last Update Date | 11/28/2007
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Provider Practice Location Address
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Address Line | 1213 13TH AVE
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City | ALTOONA
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State | PA
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Zip | 16601-3433
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Country | US
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Telephone | 814-944-4011
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Fax | 814-944-5805
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Provider Business Mailing Address
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Address Line | 1213 13TH AVE
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City | ALTOONA
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State | PA
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Zip | 16601-3433
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Country | US
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Telephone | 814-944-4011
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Fax | 814-944-5805
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Authorized Official
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Title or Position | BILLING MANAGER
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Name | MRS. MICHELLE K EDWARDS
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Credential |
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Telephone | 814-944-4011
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 152W00000X
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Taxonomy Name | Optometrist
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License Number | OEG002016
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License Number State | PA
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Taxonomy #2
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Taxonomy Code | 152W00000X
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Taxonomy Name | Optometrist
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License Number | OE004298
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License Number State | PA
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Taxonomy #3
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Taxonomy Code | 152W00000X
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Taxonomy Name | Optometrist
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License Number | OEG000688
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License Number State | PA
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