Doctor Name: | PATRICK J O'DONNELL |
NPI Number: | 1700062114 |
Entity Type Code: | Individual (1) |
Gender: | M |
Credentials: | OPTICIAN |
License Number: | |
Business Practice Address: | 2447 State Route 118 Hunlock Creek, PA - 186215022 |
Business Phone Number: | 5704771208 |
Business Fax Number: | 5704771208 |
Mailing Address: | 2447 State Route 118, HUNLOCK CREEK |
State: | PA |
Postal Code: | 186215022 |
Phone Number: | 5704771208 |
Fax Number: | 5704771208 |
NPI Enumeration Date: | 01/16/2008 |
NPI Last Update Date: | 01/16/2008 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 156FX1800X |
License Number: | |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | PA |
Taxonomy Type: | Eye and Vision Services Providers |
Taxonomy Classification: | Technician/Technologist |
Taxonomy Specialization: | Optician |
Taxonomy Definition: |