Doctor Name: | MR. ANTHONY SIMMONS |
NPI Number: | 1740653252 |
Entity Type Code: | Individual (1) |
Gender: | M |
Credentials: | ABOC |
License Number: | 138298 |
Business Practice Address: | 220 W Plum St Ste 310 Edinboro, PA - 164122166 |
Business Phone Number: | 8145804176 |
Business Fax Number: | 8145804176 |
Mailing Address: | 220 W Plum St Ste 310, EDINBORO |
State: | PA |
Postal Code: | 164122166 |
Phone Number: | 8145804176 |
Fax Number: | 8145804176 |
NPI Enumeration Date: | 11/05/2015 |
NPI Last Update Date: | 12/21/2015 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 156FX1800X |
License Number: | 138298 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | PA |
Taxonomy Type: | Eye and Vision Services Providers |
Taxonomy Classification: | Technician/Technologist |
Taxonomy Specialization: | Optician |
Taxonomy Definition: |