Organization
GWEN VINROE COLTZ, O.D., LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. GWEN VINROE COLTZ O.D. (OWNER/MEMBER)
(814) 226-3937
Entity
Organization
Contact information
Practice address
100 W MAIN ST, CLARION, PA 16214-1070
(814) 226-3937
Mailing address
100 WEST MAIN STREET, CLARION, PA 16214
(814) 226-3937
Taxonomy
Speciality
Code
Description
License number
State
152W00000X
Optometrist
Primary
OEG000433
PA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
DE3926
PALMETTO GBA- RAILROAD
PA
Enumeration date
11/14/2007
Last updated
03/20/2008
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