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General NPI Number Information
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NPI Number | 1386731727
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Entity Type | Organization
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Legal Business Name | GRETCHEN J BREWER, OD & ASSOCIATES, INC
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Dates
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Enumeration Date | 10/06/2006
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Last Update Date | 05/29/2014
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Provider Practice Location Address
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Address Line | 2329 COTTMAN AVE ROOSEVELT MALL
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City | PHILADELPHIA
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State | PA
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Zip | 19149
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Country | US
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Telephone | 215-332-7228
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Fax | 215-332-9337
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Provider Business Mailing Address
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Address Line | 2329 COTTMAN AVE ROOSEVELT MALL
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City | PHILADELPHIA
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State | PA
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Zip | 19149
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Country | US
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Telephone | 215-332-7228
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Fax | 215-332-9337
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Authorized Official
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Title or Position | PRESIDENT OWNER
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Name | GRETCHEN J BREWER
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Credential | OD
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Telephone | 215-332-7228
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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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