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General NPI Number Information
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NPI Number | 1447317524
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Entity Type | Individual
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Provider Name | TERESA MARIE FRAUNDORFER OD
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Gender | Female
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Dates
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Enumeration Date | 01/02/2007
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Last Update Date | 03/22/2016
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Provider Practice Location Address
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Address Line | 912 E ATLANTIC AVE
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City | ALTOONA
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State | PA
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Zip | 16602-6902
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Country | US
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Telephone | 814-943-0981
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Fax |
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Provider Business Mailing Address
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Address Line | 912 E ATLANTIC AVE
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City | ALTOONA
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State | PA
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Zip | 16602-6902
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Country | US
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Telephone | 814-943-0981
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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 | OEG 001344
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License Number State | PA
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