MEDICARE: JULIE ANN HALOUA O.D.

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	152W00000X	Optometrist	OEG001489	PA

General Provider Information

NPI Number	:	1790858983
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	JULIE ANN HALOUA O.D.

Provider Business Mailing Address
First Line	:	138 W COLLEGE AVE
Second Line	:
City	:	STATE COLLEGE
State	:	PA
Zip	:	16801-3838
Country	:	US
Telephone Number	:	814-234-7788
Fax Number	:	814-234-1105

Provider Business Practice Location Address
First Line	:	138 W COLLEGE AVE
Second Line	:
City	:	STATE COLLEGE
State	:	PA
Zip	:	16801-3838
Country	:	US
Telephone Number	:	814-234-7788
Fax Number	:	814-234-1105

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	11/16/2006
Last Update Date	:	07/08/2007

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