Organization Name: | JENNIFER M GUDAS OD, PC |
NPI Number: | 1073882429 |
Entity Type Code: | Organizational (2) |
Authorized Official Name: | JENNIFER M GUDAS (OPTOMETRIST) |
Mailing Address: | 633 E 13th St Winamac |
State: | IN US |
Postal Code: | 469961157 |
Phone Number: | 5749463944 |
Fax Number: | 5749466843 |
NPI Enumeration Date: | 12/14/2011 |
NPI Last Update Date: | 12/25/2011 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 332H00000X |
License Number: | 18003318B |
Healthcare Provider Taxonomy: (Secondary) | N |
State: | IN |
Taxonomy Type: | Suppliers |
Taxonomy Classification: | Eyewear Supplier (Equipment, not the service) |
Taxonomy Specialization: | |
Taxonomy Definition: | An organization that provides spectacles, contact lenses, and other vision enhancement devices prescribed by an optometrist or ophthalmologist. |