Columbus Laser Vision
Optometrist in Wilkes Barre, PA. Organization (NPI-2).
NPI number1306071766
StatusActive
Last updated in NPPESMay 28, 2009
Details
- NPI
- 1306071766
- Entity type
- Organization (NPI-2)
- Legal business name
- Columbus Laser Vision
- Organization subpart
- No
- Enumeration date
- May 28, 2009
- Last updated
- May 28, 2009
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 152W00000X | Optometrist | oeg0001371 | PA | Yes |
| 174400000X | Specialist | md072154l | PA |
Practice location
342 Wilkes Barre Township BlvdWilkes Barre, PA 18702-6708
Phone 570-824-3500
Mailing address
342 Wilkes Barre Township BlvdWilkes Barre, PA 18702-6708
Authorized official
Robert Columbus
Vp
5708243500
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