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General NPI Number Information
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NPI Number | 1073653564
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Entity Type | Organization
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Legal Business Name | DITTMAN EYECARE, INC.
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Dates
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Enumeration Date | 02/07/2007
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Last Update Date | 08/28/2013
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Provider Practice Location Address
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Address Line | 156 N MAIN ST
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City | BUTLER
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State | PA
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Zip | 16001-4927
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Country | US
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Telephone | 724-287-5739
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Fax |
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Provider Business Mailing Address
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Address Line | 156 N MAIN ST
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City | BUTLER
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State | PA
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Zip | 16001-4927
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Country | US
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Telephone | 724-287-5739
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Fax |
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Authorized Official
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Title or Position | DOCTOR
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Name | DR. MICHAEL J DITTMAN
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Credential |
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Telephone | 724-287-5739
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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 | OEG000002
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License Number State | PA
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