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Individual

TAMMRA JOY BANNER

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
OD

Contact information

Practice address
413 GERMANTOWN PIKE, SUITE 200, LAFAYETTE HILL, PA 19444-1816
(610) 825-7980
(610) 825-5398
Mailing address
413 GERMANTOWN PIKE, SUITE 200, LAFAYETTE HILL, PA 19444-1816
(610) 825-7980
(610) 825-5398

Taxonomy

Speciality
Code
Description
License number
State
152W00000X
Optometrist
27OA00537200
NJ
152W00000X
Optometrist
Primary
OEG000598
PA

Other

Enumeration date
04/18/2006
Last updated
12/05/2007
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