| NPI | 1225142003 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JOHN MALIN Optometrist 215-568-0700 |
| Organization Subpart ? | No |
| Primary Taxonomy | 152W00000X Optometrist (Licence: PA OE006597P) |
| Additional Taxonomies | 332H00000X Eyewear Supplier (Equipment, not the service) (Licence: PA OE006597P) |
| Enumeration Date | 2006-08-18 |
| Last Update Date | 2020-08-22 |