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General NPI Number Information
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NPI Number | 1801037916
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Entity Type | Organization
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Legal Business Name | JESSICA L PEEL OD PLLC
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Dates
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Enumeration Date | 03/19/2009
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Last Update Date | 03/19/2009
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Provider Practice Location Address
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Address Line | 2646 GRAND AVE STE 7
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City | BILLINGS
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State | MT
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Zip | 59102-7113
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Country | US
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Telephone | 406-256-5952
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Fax | 406-256-3837
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Provider Business Mailing Address
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Address Line | 3115 SILVERWOOD ST
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City | BILLINGS
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State | MT
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Zip | 59102-0655
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Country | US
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Telephone | 406-256-7880
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Fax | 406-545-4764
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Authorized Official
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Title or Position | SOLE MEMBER/MANAGER
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Name | DR. JESSICA LYNN PEEL
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Credential | OD
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Telephone | 406-794-7656
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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 | 787
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License Number State | MT
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