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General NPI Number Information
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NPI Number | 1174644892
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Entity Type | Individual
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Provider Name | JIL KLEIN O.D.
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Gender | Female
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Dates
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Enumeration Date | 04/02/2007
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Last Update Date | 07/08/2007
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Provider Practice Location Address
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Address Line | 1504 #20 S. SALISBURY BLVD. COURT PLAZA
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City | SALISBURY
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State | MD
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Zip | 21804
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Country | US
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Telephone | 410-334-3900
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Fax | 410-334-3955
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Provider Business Mailing Address
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Address Line | 1504 S SALISBURY BLVD 1504 #20 S. SALISBURY BLVD.
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City | SALISBURY
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State | MD
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Zip | 21801-7165
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Country | US
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Telephone | 410-334-3900
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Fax | 410-334-3955
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 152WC0802X
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Taxonomy Name | Corneal and Contact Management Optometrist
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License Number | TA1384
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License Number State | MD
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