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General NPI Number Information
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NPI Number | 1326437195
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Entity Type | Organization
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Legal Business Name | JEK ASSET MANAGEMENT, LLC
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Dates
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Enumeration Date | 01/16/2015
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Last Update Date | 01/16/2015
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Provider Practice Location Address
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Address Line | 2516 COVINGTON ST
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City | WEST LAFAYETTE
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State | IN
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Zip | 47906-1404
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Country | US
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Telephone | 765-463-4558
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Fax | 765-497-2154
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Provider Business Mailing Address
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Address Line | 2516 COVINGTON ST
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City | WEST LAFAYETTE
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State | IN
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Zip | 47906-1404
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Country | US
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Telephone | 765-463-4558
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Fax | 765-497-2154
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Authorized Official
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Title or Position | OWNER
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Name | JEFFREY E KIRCHNER
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Credential | O.D.
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Telephone | 765-463-4558
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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 | 18002997A
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License Number State | IN
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