Individual
DR. BRIAN DAVID ODONNELL
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
O.D.
Contact information
Practice address
1324 MEMORIAL HWY, SHAVERTOWN, PA 18708-1545
(570) 704-3993
(570) 704-3998
Mailing address
1324 MEMORIAL HWY, SHAVERTOWN, PA 18708-1545
(570) 704-3993
(570) 704-3998
Taxonomy
Speciality
Code
Description
License number
State
152W00000X
Optometrist
Primary
OEG000463
PA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1012666000001
—
PA
Enumeration date
07/18/2005
Last updated
01/13/2015
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