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Active
Organization subpart
No

Provider details

NPI number
Authorized official
MR. TIMOTHY PATRICK SHANAHAN OPTICIAN (TREASURER)
(610) 377-8585
Entity
Organization

Contact information

Practice address
158 MALL ROAD, LEHIGHTON, PA 18235
(610) 377-8585
(610) 377-8586
Mailing address
158 MALL ROAD, LEHIGHTON, PA 18235
(610) 377-8585
(610) 377-8586

Taxonomy

Speciality
Code
Description
License number
State
332H00000X
Eyewear Supplier
Primary

Other

Enumeration date
02/21/2008
Last updated
04/27/2008
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