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General NPI Number Information
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NPI Number | 1144644683
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Entity Type | Organization
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Legal Business Name | CHARLES M. CUMMINS, OD, PA
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Dates
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Enumeration Date | 02/04/2014
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Last Update Date | 02/04/2014
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Provider Practice Location Address
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Address Line | 748C ROUTE 73 SOUTH
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City | MARLTON
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State | NJ
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Zip | 08053
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Country | US
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Telephone | 856-596-5925
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Fax |
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Provider Business Mailing Address
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Address Line | PO BOX 848209
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City | DALLAS
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State | TX
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Zip | 75284-3668
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position | DIRECTOR
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Name | DOROTHY REYNOLDS
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Credential |
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Telephone | 856-596-5925
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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 |
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License Number State |
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