Organization
CRYSTAL CLEAR EYECARE INC.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. DAVID WILLIAM SULAK O.D. (PRESIDENT OF CORPORATION)
(215) 872-0827
Entity
Organization
Contact information
Practice address
2979 LINCOLN HWY, SADSBURYVILLE, PA 19369
(610) 857-2291
(610) 857-2297
Mailing address
PO BOX 599, 2979 LINCOLN HWY, SADSBURYVILLE, PA 19369-0599
(610) 857-2291
(610) 857-2297
Taxonomy
Speciality
Code
Description
License number
State
152W00000X
Optometrist
Primary
OEG001443
PA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0018808050004
—
PA
Enumeration date
04/20/2007
Last updated
12/27/2007
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