Organization
BOURSE OPTICAL BOUTIQUE, INC.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. JOHN K. GREGORY O.D. (PRESIDENT)
(412) 489-6726
Entity
Organization
Contact information
Practice address
2275 SWALLOW HILL RD, BUILDING 700, PITTSBURGH, PA 15220-1656
(412) 489-6726
(412) 489-6732
Mailing address
2275 SWALLOW HILL RD, BUILDING 700, PITTSBURGH, PA 15220-1656
(412) 489-6726
(412) 489-6732
Taxonomy
Speciality
Code
Description
License number
State
152W00000X
Optometrist
Primary
PAOEG001128
PA
Other
Enumeration date
06/13/2007
Last updated
03/04/2014
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