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General NPI Number Information
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NPI Number | 1306330022
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Entity Type | Individual
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Provider Name | JUSTIN SHEARMAN OD
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Gender | Male
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Dates
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Enumeration Date | 06/16/2018
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Last Update Date | 04/03/2019
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Provider Practice Location Address
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Address Line | 182 FALON LN
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City | ALTOONA
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State | PA
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Zip | 16602-6541
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Country | US
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Telephone | 814-201-5407
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Fax |
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Provider Business Mailing Address
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Address Line | 130 FOUST DR
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City | JOHNSTOWN
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State | PA
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Zip | 15904-4009
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Country | US
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Telephone | 814-341-2697
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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 | OEG003404
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License Number State | PA
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