Organization
TOM GRUDIS OPTICAL CENTER
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MRS. CAROL KOONS (BOOKKEEPER)
(570) 346-1771
Entity
Organization
Contact information
Practice address
428 SPRUCE STREET, SCRANTON, PA 18503-1821
(570) 346-1771
(570) 346-5812
Mailing address
428 SPRUCE STREET, SCRANTON, PA 18503-1821
(570) 346-1771
(570) 346-5812
Taxonomy
Speciality
Code
Description
License number
State
332H00000X
Eyewear Supplier
Primary
156FX1800X
PA
Other
Enumeration date
02/14/2008
Last updated
02/26/2008
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