Individual
TAMMY LYNN WARMOUTH
Active
Sole proprietor
Provider details
NPI number
Gender
F
Credential
OD
Contact information
Practice address
73 MAIN ST, LUZERNE, PA 18709-1201
(570) 283-0870
(570) 283-2309
Mailing address
73 MAIN ST, LUZERNE, PA 18709-1201
(570) 283-0870
(570) 283-2309
Taxonomy
Speciality
Code
Description
License number
State
152W00000X
Optometrist
Primary
OEG000060
PA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
5735329
AETNA PPO
PA
01
—
61104
GEISINGER
PA
05
—
7217744
—
PA
01
—
7686PA
VBA
PA
01
—
807807
FIRST PRIORITY
PA
01
—
837336
AETNA HMO
PA
Enumeration date
11/10/2005
Last updated
07/08/2007
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