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409 Locust Street, Suite 1, Sidman, PA 15955-0312 | |
(814) 487-6428 | |
(814) 487-6429 |
Full Name | |
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Type | Facility |
Speciality | Optometrist |
Location | 409 Locust Street, Sidman, Pennsylvania |
Accepts Medicare Assignments | Medicare enrolled and accepts medicare insurance. Providers at this facility may prescribe medicare part D drugs. |
Identifier | Type | State | Issuer |
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1942690771 | NPI | - | NPPES |
Taxonomy | Type | License (State) | Status |
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152W00000X | Optometrist | PAOEG000504 (Pennsylvania) | Primary |
Provider Name | Andrew Yourich |
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Provider Type | Practitioner - Optometry |
Provider Identifiers | NPI Number: 1720200249 PECOS PAC ID: 2668602871 Enrollment ID: I20140310001621 |
Mailing Address | Practice Location Address |
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Po Box 312, 409 Locust Street, Suite 1, Sidman, PA 15955-0312 Ph: (814) 487-6428 | 409 Locust Street, Suite 1, Sidman, PA 15955-0312 Ph: (814) 487-6428 |