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General NPI Number Information
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NPI Number | 1699324400
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Entity Type | Organization
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Legal Business Name | JASON HULL OD LLC
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Dates
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Enumeration Date | 09/05/2019
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Last Update Date | 09/18/2019
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Provider Practice Location Address
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Address Line | 45 WILLIAMSON RD
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City | GREENVILLE
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State | PA
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Zip | 16125-1253
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Country | US
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Telephone | 724-589-0234
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Fax |
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Provider Business Mailing Address
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Address Line | 1471 HENDERSONVILLE RD
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City | SANDY LAKE
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State | PA
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Zip | 16145-3419
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Country | US
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Telephone | 724-822-7911
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Fax |
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Authorized Official
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Title or Position | OPTOMETRIST
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Name | JASON HULL
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Credential | OD
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Telephone | 724-822-7911
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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 |
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License Number State |
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