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General NPI Number Information
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NPI Number | 1720467251
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Entity Type | Organization
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Legal Business Name | PLETT OPTOMETRY INC
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Dates
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Enumeration Date | 05/29/2015
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Last Update Date | 09/02/2015
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Provider Practice Location Address
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Address Line | 1001 COLORADO AVE
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City | TURLOCK
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State | CA
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Zip | 95380-2749
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Country | US
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Telephone | 209-667-6031
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Fax |
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Provider Business Mailing Address
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Address Line | 1001 COLORADO AVE
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City | TURLOCK
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State | CA
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Zip | 95380-2749
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Country | US
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Telephone | 209-667-6031
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Fax |
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Authorized Official
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Title or Position | PRESIDENT
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Name | JACOB PLETT
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Credential | O.D.
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Telephone | 209-535-6438
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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 | 15195
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License Number State | CA
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