Provider Demographics
NPI:1669610622
Name:PERRY D. CHRISTOPHER AND RHONDA A. LAUGHLIN
Entity type:Organization
Organization Name:PERRY D. CHRISTOPHER AND RHONDA A. LAUGHLIN
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:RHONDA
Authorized Official - Middle Name:A
Authorized Official - Last Name:LAUGHLIN
Authorized Official - Suffix:
Authorized Official - Credentials:OD
Authorized Official - Phone:724-832-1055
Mailing Address - Street 1:5142 ROUTE 30
Mailing Address - Street 2:
Mailing Address - City:GREENSBURG
Mailing Address - State:PA
Mailing Address - Zip Code:15601-7657
Mailing Address - Country:US
Mailing Address - Phone:724-832-1055
Mailing Address - Fax:724-832-5755
Practice Address - Street 1:5142 ROUTE 30
Practice Address - Street 2:
Practice Address - City:GREENSBURG
Practice Address - State:PA
Practice Address - Zip Code:15601-7657
Practice Address - Country:US
Practice Address - Phone:724-832-1055
Practice Address - Fax:724-832-5755
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2009-01-29
Last Update Date:2009-01-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAOEG000256332H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332H00000XSuppliersEyewear Supplier
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA1171040001Medicare NSC