Individual
DR. DANIEL REMO FATULA
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
O.D.
Contact information
Practice address
635 S BRADY ST, DU BOIS, PA 15801-1202
(814) 503-4100
(814) 503-4157
Mailing address
635 S BRADY ST, DU BOIS, PA 15801-1202
(814) 503-4100
(814) 503-4157
Taxonomy
Speciality
Code
Description
License number
State
152W00000X
Optometrist
Primary
OEG001789
PA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1024126310002
—
PA
Enumeration date
08/20/2006
Last updated
05/07/2024
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