Organization
WILLIAM REYNOLDS SISSON
Active
Organization subpart
No
Provider details
NPI number
Authorized official
ANNMARIE LIDDICK (OFFICE MANAGER)
(717) 567-3103
Entity
Organization
Contact information
Practice address
7 CRAMER DR, NEWPORT, PA 17074-8720
(717) 567-3103
(717) 567-7784
Mailing address
7 CRAMER DR, PO BOX 70, NEWPORT, PA 17074-8720
(717) 567-3103
(717) 567-7784
Taxonomy
Speciality
Code
Description
License number
State
152W00000X
Optometrist
Primary
OEG000258
PA
152WC0802X
Corneal and Contact Management Optometrist
OEG000258
PA
152WP0200X
Pediatric Optometrist
OEG000258
PA
152WS0006X
Sports Vision Optometrist
OEG000258
PA
152WV0400X
Vision Therapy Optometrist
OEG000258
PA
152WX0102X
Occupational Vision Optometrist
OEG000258
PA
Other
Enumeration date
09/22/2006
Last updated
05/21/2008
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