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NPI 1538573506

NPI 1538573506 : GIFFORD PIPER O.D. : ALTOONA, PA

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General NPI Number Information
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    NPI Number           |    1538573506
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    Entity Type          |    Individual 
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    Provider Name        |    GIFFORD PIPER O.D.
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    Gender               |    Male 
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Dates
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    Enumeration Date     |    06/17/2014
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    Last Update Date     |    06/17/2014
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Provider Practice Location Address
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    Address Line         |    515 26TH ST 
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    City                 |    ALTOONA
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    State                |    PA
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    Zip                  |    16602-2026
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    Country              |    US
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    Telephone            |    814-942-3200
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    Fax                  |    
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Provider Business Mailing Address
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    Address Line         |    515 26TH ST 
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    City                 |    ALTOONA
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    State                |    PA
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    Zip                  |    16602-2026
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    Country              |    US
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    Telephone            |    814-942-3200
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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       |    OEG002780
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    License Number State |    PA
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