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General NPI Number Information
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NPI Number | 1669529293
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Entity Type | Organization
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Legal Business Name | DESIGNER EYEGLASS, LTD
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Dates
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Enumeration Date | 01/04/2007
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Last Update Date | 05/08/2008
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Provider Practice Location Address
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Address Line | 1125 N 4TH ST
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City | SUNBURY
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State | PA
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Zip | 17801-1229
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Country | US
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Telephone | 570-286-3944
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Fax |
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Provider Business Mailing Address
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Address Line | 1125 N 4TH ST
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City | SUNBURY
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State | PA
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Zip | 17801-1229
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Country | US
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Telephone | 570-286-3944
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Fax |
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Authorized Official
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Title or Position | OPTOMETRIST
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Name | AMY SPOTTS
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Credential | O.D.
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Telephone | 570-286-3944
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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 |
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License Number State |
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