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Individual

MRS. SUSAN A SHORE

Active
Sole proprietor
No

Provider details

NPI number
Gender
F

Contact information

Practice address
214 W MAIN ST, SUITE 102, MOORESTOWN, NJ 08057-2345
(856) 273-8565
(215) 496-1693
Mailing address
214 W MAIN ST, SUITE 102, MOORESTOWN, NJ 08057-2345
(856) 273-8565
(215) 496-1693

Taxonomy

Speciality
Code
Description
License number
State
156FX1700X
Ocularist
Primary

Other

Enumeration date
05/15/2007
Last updated
11/12/2007
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