Individual
PETER G THEODOROUS
Active
Sole proprietor
Provider details
NPI number
Gender
Man
Credential
OD
Contact information
Practice address
4570 PENNS VALLEY RD, SUITE 3, SPRING MILLS, PA 16875-8500
(814) 422-8006
(814) 422-8561
Mailing address
428 WINDMERE DR, SUITE 100, STATE COLLEGE, PA 16801-7668
(814) 234-2015
(814) 238-5300
Taxonomy
Speciality
Code
Description
License number
State
152W00000X
Optometrist
Primary
OEG000709
PA
Other
Enumeration date
10/04/2005
Last updated
07/08/2007
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