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General NPI Number Information
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NPI Number | 1275843849
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Entity Type | Organization
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Legal Business Name | JOLENE HANN INC
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Dates
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Enumeration Date | 10/18/2010
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Last Update Date | 10/18/2010
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Provider Practice Location Address
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Address Line | 1300 E ASH ST
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City | PIQUA
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State | OH
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Zip | 45356-4100
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Country | US
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Telephone | 937-615-9982
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Fax |
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Provider Business Mailing Address
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Address Line | 742 WASHINGTON AVE
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City | GREENVILLE
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State | OH
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Zip | 45331-1266
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position | PRESIDENT
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Name | JOLENE STEWART
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Credential | O.D.
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Telephone | 937-467-1074
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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 | 5794
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License Number State | OH
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