Organization
GOOD LOOKS EYEWEAR INC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
WILLIAM CLARK CHRISTIE MD (OWNER PHYSICIAN)
(724) 772-5420
Entity
Organization
Contact information
Practice address
20215 ROUTE 19, SUITE 104, CRANBERRY TWP, PA 16066-6146
(724) 772-9090
(724) 772-9160
Mailing address
105 BRANDT DR, SUITE 300, CRANBERRY TWP, PA 16066-6437
(724) 772-5474
(724) 772-5423
Taxonomy
Speciality
Code
Description
License number
State
332H00000X
Eyewear Supplier
Primary
MD037014E
PA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
001738360007
—
PA
01
—
GL000256582
BLUESHIELD
PA
Enumeration date
11/02/2005
Last updated
07/03/2013
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