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General NPI Number Information
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NPI Number | 1629162482
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Entity Type | Individual
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Provider Name | DAVID JOHN KRILEY OD
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Gender | Male
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Dates
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Enumeration Date | 10/03/2006
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Last Update Date | 12/20/2011
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Provider Practice Location Address
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Address Line | 35 PLAZA DR RTE 309 NORTH
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City | TAMAQUA
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State | PA
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Zip | 18252-4405
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Country | US
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Telephone | 570-668-2672
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Fax | 570-668-2683
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Provider Business Mailing Address
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Address Line | 35 PLAZA DRIVE ROUTE 309 NORTH
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City | TAMAQUA
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State | PA
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Zip | 18252-4450
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Country | US
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Telephone | 570-668-2672
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Fax | 570-668-2683
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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 | OE005128T
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License Number State | PA
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