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Organization

HARRISON-KULBACK EYECARE

Active
Parent organization
KULBACK EYECARE INC
Organization subpart
Yes

Provider details

NPI number
Legal business name
KULBACK EYECARE INC
Authorized official
KENNETH JOSEPH KULBACK DC (PRESIDENT)
(814) 266-6888
Entity
Organization

Contact information

Practice address
1110 SCALP AVENUE, JOHNSTOWN, PA 15904-3037
(814) 266-6888
(814) 262-0267
Mailing address
1110 SCALP AVENUE, JOHNSTOWN, PA 15904-3037
(814) 266-6888
(814) 262-0267

Taxonomy

Speciality
Code
Description
License number
State
152W00000X
Optometrist
Primary
OE007853P
PA

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
0015774560007
PA
05
0015774560008
PA
01
1780768515
INDIVAL NPI NUMBER
PA
01
910853
EYE MED
PA
01
HA1886072
BLUE CROSS ID NUMBER
PA
Enumeration date
11/06/2007
Last updated
06/14/2023
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