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General NPI Number Information
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NPI Number | 1861460909
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Entity Type | Organization
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Legal Business Name | JMAM INC.
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Dates
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Enumeration Date | 03/14/2006
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Last Update Date | 01/09/2023
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Provider Practice Location Address
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Address Line | 265 S HOUCKS RD
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City | HARRISBURG
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State | PA
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Zip | 17109-2907
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Country | US
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Telephone | 717-564-7015
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Fax | 717-564-7189
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Provider Business Mailing Address
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Address Line | 265 S HOUCKS RD
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City | HARRISBURG
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State | PA
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Zip | 17109-2907
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Country | US
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Telephone | 717-564-7015
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Fax | 717-564-7189
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Authorized Official
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Title or Position | OWNER
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Name | DR. JONATHAN ROBERT MURPHY
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Credential | O.D.
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Telephone | 717-564-7015
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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 | OEG001471
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License Number State | PA
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