Individual
DR. MARTHA SHIPE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
O.D.
Contact information
Practice address
390 PIERCE ST, KINGSTON, PA 18704-5532
(570) 714-2600
(570) 714-9790
Mailing address
390 PIERCE ST, KINGSTON, PA 18704-5532
(570) 714-2600
(570) 714-9790
Taxonomy
Speciality
Code
Description
License number
State
152W00000X
Optometrist
Primary
OEG000462
PA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0012965440002
—
PA
Enumeration date
07/12/2005
Last updated
03/30/2011
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