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General NPI Number Information
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NPI Number | 1407145089
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Entity Type | Organization
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Legal Business Name | JEFFREY L. VARNER
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Dates
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Enumeration Date | 04/04/2011
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Last Update Date | 04/12/2011
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Provider Practice Location Address
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Address Line | 116 S MAIN ST
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City | NORTH WALES
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State | PA
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Zip | 19454-2833
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Country | US
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Telephone | 215-699-2020
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Fax | 215-699-2020
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Provider Business Mailing Address
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Address Line | 116 S MAIN ST
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City | NORTH WALES
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State | PA
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Zip | 19454-2833
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Country | US
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Telephone | 215-699-2020
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Fax | 215-699-2020
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Authorized Official
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Title or Position | OWNER
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Name | DR. JEFFREY L VARNER
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Credential | OD
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Telephone | 215-699-2020
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 332H00000X
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Taxonomy Name | Eyewear Supplier
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License Number | PA-06648-T
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License Number State | PA
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