| NPI | 1104882208 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | MARTINA ANN MANCUSO Office Manager 724-459-6610 |
| Organization Subpart ? | No |
| Primary Taxonomy | 152W00000X Optometrist (Licence: PA OEG000818) |
| Enumeration Date | 2006-04-26 |
| Last Update Date | 2015-01-13 |