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Individual

MELISSA NANCY RANDECKER

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F
Credential
O.D.

Contact information

Practice address
930 BELLEFONTE AVE, LOCK HAVEN, PA 17745-2754
(570) 748-8900
(570) 748-3200
Mailing address
930 BELLEFONTE AVE, LOCK HAVEN, PA 17745-2754
(570) 748-8900
(570) 748-3200

Taxonomy

Speciality
Code
Description
License number
State
152W00000X
Optometrist
Primary
OET08717
PA

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
1022033460001
PA
Enumeration date
10/24/2006
Last updated
10/20/2022
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