Organization
DR. WAYNE A. MUNDIS
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. WAYNE ALAN MUNDIS O.D. (OWNER)
(717) 235-1346
Entity
Organization
Contact information
Practice address
46 WATER ST, GLEN ROCK, PA 17327-1011
(717) 235-1346
(717) 235-4843
Mailing address
46 WATER ST, GLEN ROCK, PA 17327-1011
(717) 235-1346
(717) 235-4843
Taxonomy
Speciality
Code
Description
License number
State
332H00000X
Eyewear Supplier
Primary
5274-P
PA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0516520001
DMERC REGION A
PA
Enumeration date
11/15/2007
Last updated
11/15/2007
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