Organization Name: | GARNET VALLEY EYE CARE PC |
NPI Number: | 1548658180 |
Entity Type Code: | Organizational (2) |
Authorized Official Name: | HOLLY SALLOGA (OPTOMETRIST) |
Mailing Address: | 494 Conchester Hwy Aston |
State: | PA US |
Postal Code: | 190141855 |
Phone Number: | 6108590120 |
Fax Number: | |
NPI Enumeration Date: | 01/06/2015 |
NPI Last Update Date: | 07/30/2015 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 261QP2300X |
License Number: | OE008544T |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | PA |
Taxonomy Type: | Ambulatory Health Care Facilities |
Taxonomy Classification: | Clinic/Center |
Taxonomy Specialization: | Primary Care |
Taxonomy Definition: |