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Individual

MRS. DIANA JO KAHLEY

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F

Contact information

Practice address
146 W ADAMS ST, COCHRANTON, PA 16314
(814) 425-3937
(814) 425-3378
Mailing address
PO BOX 392, 146 W ADAMS ST, COCHRANTON, PA 16314
(814) 425-3937
(814) 425-3378

Taxonomy

Speciality
Code
Description
License number
State
152W00000X
Optometrist
4607T1350
OH
152W00000X
Optometrist
Primary
OEG000457
PA

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
2426299
OH
05
990320
PA
Enumeration date
09/26/2006
Last updated
06/07/2008
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