Individual
BOB L LAZER
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
OD
Contact information
Practice address
120 W PENN ST, BEDFORD, PA 15522-1223
(814) 623-5018
(814) 623-7718
Mailing address
120 W PENN ST, BEDFORD, PA 15522-1223
(814) 623-5018
(814) 623-7718
Taxonomy
Speciality
Code
Description
License number
State
152W00000X
Optometrist
Primary
OEG001149
PA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
LA435357
BLUE SHIELD
PA
Enumeration date
09/02/2005
Last updated
05/22/2008
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