Provider Demographics
NPI:1437142825
Name:MATZ, ALBERT BRUCE (OD)
Entity Type:Individual
Prefix:DR
First Name:ALBERT
Middle Name:BRUCE
Last Name:MATZ
Suffix:
Gender:M
Credentials:OD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1022 CENTRE ST
Mailing Address - Street 2:
Mailing Address - City:ASHLAND
Mailing Address - State:PA
Mailing Address - Zip Code:17921-1245
Mailing Address - Country:US
Mailing Address - Phone:570-875-3851
Mailing Address - Fax:570-875-3857
Practice Address - Street 1:1022 CENTRE ST
Practice Address - Street 2:
Practice Address - City:ASHLAND
Practice Address - State:PA
Practice Address - Zip Code:17921-1245
Practice Address - Country:US
Practice Address - Phone:570-875-3851
Practice Address - Fax:570-875-3857
Is Sole Proprietor?:No
Enumeration Date:2005-08-31
Last Update Date:2016-03-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAOEG000988152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152W00000XEye and Vision Services ProvidersOptometrist