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NPI Code Detail

MEDICARE: DR. JENNA KIM TREIBER O.D

MEDICARE: DR. JENNA KIM TREIBER O.D
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1152W00000XOptometrist2009AZ

General Provider Information

NPI Number : 1740698307
Entity Type Code : Individual
Provider Name (Legal Business Name) : DR. JENNA KIM TREIBER O.D
Provider Business Mailing Address
First Line : 3788 S 16TH AVE
Second Line :
City : TUCSON
State : AZ
Zip : 85713-6079
Country : US
Telephone Number : 520-388-9741
Fax Number :
Provider Business Practice Location Address
First Line : 3788 S 16TH AVE
Second Line :
City : TUCSON
State : AZ
Zip : 85713-6079
Country : US
Telephone Number : 520-388-9741
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 07/28/2014
Last Update Date : 08/17/2014

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