| NPI | 1780955575 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | RAFAEL S COLAZZO O PT Ometrist 215-455-1010 |
| Organization Subpart ? | No |
| Primary Taxonomy | 152W00000X Optometrist (Licence: PA OE006393T) |
| Additional Taxonomies | 207W00000X Ophthalmology (Licence: PA OE006393T) |
| 213E00000X Podiatrist (Licence: PA OE006393T) | |
| Enumeration Date | 2012-01-25 |
| Last Update Date | 2013-04-25 |