Organization
KENNETH R GIFT OD
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. KENNTH R GIFT (OWNER)
(570) 374-0154
Entity
Organization
Contact information
Practice address
886 ROUTE 522, SELINSGROVE, PA 17870-9712
(570) 374-0154
(570) 374-0155
Mailing address
886 ROUTE 522, SELINSGROVE, PA 17870-9712
(570) 374-0154
(570) 374-0155
Taxonomy
Speciality
Code
Description
License number
State
332H00000X
Eyewear Supplier
Primary
G000099
PA
Other
Enumeration date
03/27/2008
Last updated
02/13/2013
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