Individual
MICHELLE A WETHERHOLD
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
OD
Contact information
Practice address
235 DIVISION ST, HARRISBURG, PA 17110-1213
(717) 233-8783
(717) 233-2221
Mailing address
235 DIVISION ST, HARRISBURG, PA 17110-1213
(717) 233-8783
(717) 233-2221
Taxonomy
Speciality
Code
Description
License number
State
152W00000X
Optometrist
Primary
OEG000331
PA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1345227
BLUE SHIELD
—
01
—
50003483
BLUE CROSS
—
Enumeration date
09/02/2005
Last updated
02/25/2010
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