Individual
DR. TODD MICHAEL KEPPICH
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
O.D.
Contact information
Practice address
2121 SHELLY DR, INDIANA, PA 15701-2395
(724) 349-1237
(724) 465-0127
Mailing address
2121 SHELLY DR, INDIANA, PA 15701-2395
(724) 349-1237
(724) 465-0127
Taxonomy
Speciality
Code
Description
License number
State
152W00000X
Optometrist
0601800384
VA
152W00000X
Optometrist
Primary
OEG002045
PA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0601800384
STATE LICENSE NUMBER
VA
01
—
OEG002045
STATE LICENSE
PA
Enumeration date
11/07/2005
Last updated
08/08/2011
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