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General NPI Number Information
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NPI Number | 1881935260
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Entity Type | Organization
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Legal Business Name | DR THOMAS E PATRICK & ASSOCIATES, PC
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Dates
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Enumeration Date | 03/08/2013
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Last Update Date | 03/08/2013
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Provider Practice Location Address
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Address Line | 1500 W CHESTNUT ST WASHINGTON CROWN CENTER
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City | WASHINGTON
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State | PA
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Zip | 15301-5864
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Country | US
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Telephone | 724-228-7338
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Fax |
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Provider Business Mailing Address
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Address Line | 1500 W CHESTNUT ST WASHINGTON CROWN CENTER
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City | WASHINGTON
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State | PA
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Zip | 15301-5864
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Country | US
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Telephone | 724-228-7338
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Fax |
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Authorized Official
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Title or Position | OWNER
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Name | DR. THOMAS EDWARD PATRICK
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Credential | O.D.
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Telephone | 724-228-7338
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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 | OEG001368
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License Number State | PA
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