| NPI | 1104103456 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | GERALD M. STEFANIC O PT Ician/Owner 814-454-7138 |
| Organization Subpart ? | No |
| Primary Taxonomy | 152W00000X Optometrist (Licence: PA OEGOO1057) |
| Additional Taxonomies | 156F00000X Technician/Technologist |
| Enumeration Date | 2011-11-14 |
| Last Update Date | 2011-11-14 |