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General NPI Number Information
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NPI Number | 1093017428
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Entity Type | Organization
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Legal Business Name | CHARLES WHITLING INC
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Dates
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Enumeration Date | 11/17/2010
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Last Update Date | 11/17/2010
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Provider Practice Location Address
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Address Line | 679A KIDDER ST
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City | WILKES BARRE
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State | PA
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Zip | 18702-6908
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Country | US
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Telephone | 570-824-5715
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Fax | 570-824-1512
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Provider Business Mailing Address
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Address Line | 679A KIDDER ST
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City | WILKES BARRE
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State | PA
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Zip | 18702-6908
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Country | US
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Telephone | 570-824-5715
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Fax | 570-824-1512
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Authorized Official
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Title or Position | OPTOMETRIST
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Name | MR. CHARLES P WHITLING
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Credential | O.D.
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Telephone | 570-824-5715
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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 | OEG001829
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License Number State | PA
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