| NPI | 1417033861 |
|---|---|
| Former Legal Business Name | MARK V GRAYTOK |
| Entity Type | Organization |
| Authorized Contact | TERESE F JUPENA Billing COO Rdinator 724-834-8033 |
| Organization Subpart ? | |
| Primary Taxonomy | 152W00000X Optometrist (Licence: PA OEG001356) |
| Enumeration Date | 2006-10-28 |
| Last Update Date | 2024-10-01 |