| Doctor Name: | MR. TREONDAUS GARNETT MORMAN |
| NPI Number: | 1528301173 |
| Entity Type Code: | Individual (1) |
| Gender: | M |
| Credentials: | ABOCERTIFIED OPTICAN |
| License Number: | 142273 |
| Business Practice Address: | 1135 Santiam Hwy Se Albany, OR - 973213156 |
| Business Phone Number: | 5417305712 |
| Business Fax Number: | |
| Mailing Address: | 1135 Santiam Hwy Se, ALBANY |
| State: | OR |
| Postal Code: | 973213156 |
| Phone Number: | 5417305712 |
| Fax Number: | |
| NPI Enumeration Date: | 04/02/2013 |
| NPI Last Update Date: | 04/02/2013 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 332H00000X |
| License Number: | 142273 |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | OR |
| Taxonomy Type: | Suppliers |
| Taxonomy Classification: | Eyewear Supplier (Equipment, not the service) |
| Taxonomy Specialization: | |
| Taxonomy Definition: | An organization that provides spectacles, contact lenses, and other vision enhancement devices prescribed by an optometrist or ophthalmologist. |