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General NPI Number Information
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NPI Number | 1265962419
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Entity Type | Organization
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Legal Business Name | DR MELANIE J JONES OPTOMETRIST PC
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Dates
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Enumeration Date | 06/19/2017
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Last Update Date | 05/25/2018
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Provider Practice Location Address
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Address Line | 5770 CLEVELAND AVE
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City | STEVENSVILLE
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State | MI
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Zip | 49127
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Country | US
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Telephone | 269-208-3645
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Fax |
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Provider Business Mailing Address
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Address Line | 5770 CLEVELAND AVE
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City | STEVENSVILLE
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State | MI
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Zip | 49127-9481
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Country | US
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Telephone | 269-408-8221
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Fax |
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Authorized Official
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Title or Position | PRESIDENT
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Name | DR. MELANIE JANKOWSKI JONES
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Credential | OD
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Telephone | 269-408-8221
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 152W00000X
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Taxonomy Name | Optometrist
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License Number | 4901003793
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License Number State | MI
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