Organization
INDEPENDENCE CORPORATION
Active
Parent organization
INDEPENDENCE CORPORATION
Other names
EYELAND OPTICAL INC
Organization subpart
Yes
Provider details
NPI number
Legal business name
INDEPENDENCE CORPORATION
Authorized official
LISA PAUSINGER (INS AR)
(610) 799-2020
Entity
Organization
Contact information
Practice address
3090 N SUSQUEHANNA TRAIL RD, SHAMOKIN DAM, PA 17876
(570) 743-3937
(570) 743-3005
Mailing address
4119 MAUCH CHUNK RD # C, COPLAY, PA 18037-2106
(610) 799-2020
(610) 799-4399
Taxonomy
Speciality
Code
Description
License number
State
152W00000X
Optometrist
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0018518950002
—
PA
Enumeration date
03/30/2009
Last updated
03/06/2012
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