Individual
WILLIAM BLAINE SHUKE
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
O.D.
Contact information
Practice address
311 HOSPITAL DR, EVERETT, PA 15537-7022
(814) 623-1969
(814) 623-5590
Mailing address
311 HOSPITAL DR, EVERETT, PA 15537-7022
(814) 623-1969
(814) 623-5590
Taxonomy
Speciality
Code
Description
License number
State
152W00000X
Optometrist
Primary
OEG000761
PA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0016242330004
—
PA
Enumeration date
09/16/2006
Last updated
12/10/2015
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