Jon David Heaverlo, O.D. Valid NPI

Individual provider · Optometrist · Chariton, IA

NPI

1669437968

Type

Individual (Type 1)

Primary specialty

Optometrist

Specialty group

Eye and Vision Services Providers

Taxonomy code

152W00000X

License number

02187 (IA)

Sex

Male

Sole proprietor

No

Enumerated

2006-04-19

Last updated

2007-09-27