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General NPI Number Information
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NPI Number | 1497179840
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Entity Type | Organization
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Legal Business Name | JJ'S OPTICAL
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Dates
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Enumeration Date | 02/05/2014
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Last Update Date | 02/05/2014
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Provider Practice Location Address
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Address Line | 3601 S CLARKSON ST SUITE 115
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City | ENGLEWOOD
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State | CO
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Zip | 80113-3944
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Country | US
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Telephone | 303-781-9151
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Fax | 303-781-1343
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Provider Business Mailing Address
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Address Line | 3601 S CLARKSON ST SUITE 115
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City | ENGLEWOOD
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State | CO
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Zip | 80113-3944
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Country | US
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Telephone | 303-781-9151
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Fax | 303-781-1343
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Authorized Official
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Title or Position | OWNER
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Name | DR. GARY ALAN JAMELL
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Credential | M.D.
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Telephone | 303-781-9151
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 332H00000X
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Taxonomy Name | Eyewear Supplier
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License Number |
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License Number State |
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