Individual
KELLY MORITZ
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
O.D.
Contact information
Practice address
4002 CHESTNUT ST, PHILADELPHIA, PA 19104
(215) 921-4871
Mailing address
37 BONNYWICK DR, HARRISBURG, PA 17111-4933
(717) 319-0778
Taxonomy
Speciality
Code
Description
License number
State
152W00000X
Optometrist
I3-0001391
DE
152W00000X
Optometrist
Primary
OEG003227
PA
Other
Enumeration date
02/26/2017
Last updated
08/13/2018
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