Jerry B Park, OP Valid NPI

Individual provider · Optometrist · Jacksonville, AR

NPI

1235254095

Type

Individual (Type 1)

Primary specialty

Optometrist

Specialty group

Eye and Vision Services Providers

Taxonomy code

152W00000X

License number

OP1100081 (AR)

Sex

Male

Sole proprietor

No

Enumerated

2007-03-20

Last updated

2007-07-08