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Individual

DR. TAMMY LYNN CARLSON

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F
Credential
OD

Contact information

Practice address
852 MAIN ST, VANDLING, PA 18421-1549
(570) 785-5367
Mailing address
852 MAIN ST, VANDLING, PA 18421-1549
(570) 785-5367

Taxonomy

Speciality
Code
Description
License number
State
152W00000X
Optometrist
Primary
OEG000885
PA
152W00000X
Optometrist
TUV0061061
NY

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
0019400280001
PA
01
P00775085
MEDICARE RAILROAD PTAN
PA
Enumeration date
03/23/2006
Last updated
06/18/2025
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