Individual
DR. AVERY B BOARDMAN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
OD
Contact information
Practice address
889 CRAFTMASTER ROAD, WYSOX, PA 18854-0000
(570) 265-3668
(570) 265-8936
Mailing address
889 CRAFTMASTER ROAD, PO BOX 331, WYSOX, PA 18854-0000
(570) 265-3668
(570) 265-8936
Taxonomy
Speciality
Code
Description
License number
State
152W00000X
Optometrist
Primary
OEG000896
PA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0012690190004
—
PA
Enumeration date
10/13/2006
Last updated
03/23/2011
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