Provider Demographics
NPI:1386899474
Name:DIMON, PAUL CLAY (OPTICIAN)
Entity type:Individual
Prefix:
First Name:PAUL
Middle Name:CLAY
Last Name:DIMON
Suffix:
Gender:M
Credentials:OPTICIAN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:608 E GRAND AVE
Mailing Address - Street 2:
Mailing Address - City:TOWER CITY
Mailing Address - State:PA
Mailing Address - Zip Code:17980
Mailing Address - Country:US
Mailing Address - Phone:717-647-9005
Mailing Address - Fax:
Practice Address - Street 1:608 E GRAND AVE
Practice Address - Street 2:WILLIAMS VALLEY OPT.
Practice Address - City:TOWER CITY
Practice Address - State:PA
Practice Address - Zip Code:17980
Practice Address - Country:US
Practice Address - Phone:717-647-9005
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2008-11-18
Last Update Date:2008-11-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes156FX1800XEye and Vision Services ProvidersTechnician/TechnologistOptician