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General NPI Number Information
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NPI Number | 1700098555
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Entity Type | Organization
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Legal Business Name | KNK VISION CORP
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Dates
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Enumeration Date | 05/04/2007
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Last Update Date | 07/21/2022
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Provider Practice Location Address
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Address Line | 205 MONTGOMERY MALL
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City | NORTH WALES
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State | PA
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Zip | 19454-3905
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Country | US
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Telephone | 215-362-2422
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Fax |
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Provider Business Mailing Address
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Address Line | 205 MONTGOMERY MALL
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City | NORTH WALES
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State | PA
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Zip | 19454-3905
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Country | US
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Telephone | 215-362-2422
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Fax |
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Authorized Official
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Title or Position | OWNER
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Name | GARY KASCHAK
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Credential |
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Telephone | 215-362-2422
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 156F00000X
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Taxonomy Name | Technician/Technologist
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License Number |
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License Number State | PA
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