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Individual

MR. JOHN J BAAB SR.

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
OPTICIAN

Contact information

Practice address
165 N MOUNTAIN BLVD, MOUNTAIN TOP, PA 18707-1127
(570) 474-9082
(570) 474-9760
Mailing address
165 N MOUNTAIN BLVD, MOUNTAIN TOP, PA 18707-1127
(570) 474-9082
(570) 474-9760

Taxonomy

Speciality
Code
Description
License number
State
156FX1800X
Optician
Primary
09951

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
112112
EYEMED
01
200505
BELBS
01
393134
NVA
Enumeration date
01/25/2007
Last updated
07/08/2007
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