Robert Dewey Blase, OD
Optometrist in Wyoming, PA. Individual provider (NPI-1).
NPI number1477513612
StatusActive
Last updated in NPPESFeb 21, 2014
Details
- NPI
- 1477513612
- Entity type
- Individual (NPI-1)
- Name
- Robert Dewey Blase
- Credential
- OD
- Sex
- Male
- Sole proprietor
- No
- Enumeration date
- Mar 23, 2006
- Last updated
- Feb 21, 2014
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 152W00000X | Optometrist | OEG000804 | PA | Yes |
Practice location
155 Wyoming AveWyoming, PA 18644-1708
Phone 570-693-1578 · Fax 570-693-2010
Mailing address
703 Rutter AveKingston, PA 18704-4801
Phone 570-288-7405 · Fax 570-288-7406
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