Individual
ROBERT DEWEY BLASE
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
OD
Contact information
Practice address
155 WYOMING AVE, WYOMING, PA 18644-1708
(570) 693-1578
(570) 693-2010
Mailing address
703 RUTTER AVE, KINGSTON, PA 18704-4801
(570) 288-7405
(570) 288-7406
Taxonomy
Speciality
Code
Description
License number
State
152W00000X
Optometrist
Primary
OEG000804
PA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
000901188
—
PA
Enumeration date
03/23/2006
Last updated
02/21/2014
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