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Individual
JESSA MARIE VANKLEECK
Active
Individual
JESSA MARIE VANKLEECK
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
OD
Taxonomy
Speciality
Code
Description
License number
State
152W00000X
Optometrist
Primary
OPT34433TLG
CA
152W00000X
Optometrist
TUV008978
NY
Other
Enumeration date
06/17/2019
Last updated
03/19/2020
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