Individual
JOHN JOSEPH SHEDLOCK
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
O.D.
Contact information
Practice address
612 CLARA ST STE 1, HOUTZDALE, PA 16651-1115
(814) 378-7700
(814) 378-7704
Mailing address
612 CLARA ST SUITE 1, HOUTZDALE, PA 16651-9510
(814) 378-7700
(814) 378-7704
Taxonomy
Speciality
Code
Description
License number
State
152W00000X
Optometrist
Primary
OEG002084
PA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
102260899 0001
—
PA
Enumeration date
07/28/2008
Last updated
09/19/2012
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