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Organization
MARK A. JURY OPTOMETRIC PROFESSIONAL CORPORATION
Active
Organization
MARK A. JURY OPTOMETRIC PROFESSIONAL CORPORATION
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. MARK ALAN JURY O.D. (OPTOMETRIST)
(951) 304-9733
Entity
Organization
Contact information
Practice address
23905 CLINTON KEITH ROAD, SUITE 115, WILDOMAR, CA 92595-7899
(951) 304-9733
(951) 304-9734
Mailing address
23905 CLINTON KEITH ROAD, SUITE 115, WILDOMAR, CA 92595-7899
(951) 304-9733
(951) 304-9734
Taxonomy
Speciality
Code
Description
License number
State
152W00000X
Optometrist
Primary
9583 T
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
SD0095830
—
CA
Enumeration date
10/24/2006
Last updated
09/19/2011
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