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Individual

WILLIAM R. FORSE

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man
Credential
OD

Contact information

Practice address
1 OUTLET LN, SUITE 310, LOCK HAVEN, PA 17745-9794
(570) 769-2877
(570) 769-2879
Mailing address
PO BOX 524, MC ELHATTAN, PA 17748-0524
(570) 769-2877
(570) 769-2879

Taxonomy

Speciality
Code
Description
License number
State
152W00000X
Optometrist
Primary
OEG000027
PA

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
001863439
PA
01
1900886
HIGHMARK BLUE SHIELD
PA
01
75790 163H
GEISINGER
PA
Enumeration date
04/26/2006
Last updated
09/29/2008
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