Doctor Name: | MRS. JENNIFER LYNN SOWERS |
NPI Number: | 1619158961 |
Entity Type Code: | Individual (1) |
Gender: | F |
Credentials: | CERTIFIED OPTICIAN |
License Number: | 168711 |
Business Practice Address: | 105 1/2 W Walnut St Oglesby, IL - 613481215 |
Business Phone Number: | 8158839822 |
Business Fax Number: | 8158839822 |
Mailing Address: | 105 1/2 W Walnut St, OGLESBY |
State: | IL |
Postal Code: | 613481215 |
Phone Number: | 8158839822 |
Fax Number: | 8158839822 |
NPI Enumeration Date: | 11/15/2007 |
NPI Last Update Date: | 08/22/2008 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 156FX1800X |
License Number: | 168711 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | IL |
Taxonomy Type: | Eye and Vision Services Providers |
Taxonomy Classification: | Technician/Technologist |
Taxonomy Specialization: | Optician |
Taxonomy Definition: |