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General NPI Number Information
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NPI Number | 1073561981
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Entity Type | Individual
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Provider Name | GARY L SCHEIB
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Gender | Male
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Dates
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Enumeration Date | 05/04/2006
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Last Update Date | 03/30/2012
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Provider Practice Location Address
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Address Line | 307 MAHANTONGO ST
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City | POTTSVILLE
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State | PA
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Zip | 17901-3061
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Country | US
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Telephone | 570-622-3937
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Fax |
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Provider Business Mailing Address
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Address Line | P.O. BOX 420
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City | POTTSVILLE
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State | PA
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Zip | 17901-0420
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Country | US
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Telephone | 570-622-3937
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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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 | 0EG001179
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License Number State | PA
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Taxonomy #2
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Taxonomy Code | 332H00000X
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Taxonomy Name | Eyewear Supplier
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License Number | OEG00179
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License Number State | PA
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