Individual
LOUISA C. GAITER JOHNSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
O.D.
Contact information
Practice address
1568 WOODBOURNE RD, LEVITTOWN, PA 19057-1508
(215) 943-7800
(215) 943-6254
Mailing address
1568 WOODBOURNE RD, LEVITTOWN, PA 19057-1508
(215) 943-7800
(215) 943-6254
Taxonomy
Speciality
Code
Description
License number
State
152W00000X
Optometrist
Primary
OEG002343
PA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
OEG002343
PA OPTOMETRIC LICENSE
PA
Enumeration date
07/28/2010
Last updated
07/28/2010
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