| NPI | 1699941179 |
|---|---|
| Former Legal Business Name | DR. MICHELE Y. SHADE, OPTOMETRIST |
| Entity Type | Organization |
| Authorized Contact | MICHELE SHADE Owner 610-326-1106 |
| Organization Subpart ? | No |
| Primary Taxonomy | 152W00000X Optometrist (Licence: PA OEG000169) |
| Additional Taxonomies | 332H00000X Eyewear Supplier (Equipment, not the service) (Licence: PA OEG000169) |
| Enumeration Date | 2008-05-05 |
| Last Update Date | 2010-08-10 |