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Organization
JLR FAMILY PRACTICE, PC
Active
Organization
JLR FAMILY PRACTICE, PC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
JENNIFER LYNN RICHARDSON (PRESIDENT)
(812) 634-7726
Entity
Organization
Contact information
Practice address
3404 NEWTON ST, JASPER, IN 47546-1020
(812) 634-7726
Mailing address
3404 NEWTON ST, JASPER, IN 47546-1020
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
01047337A
IN
Other
Enumeration date
07/05/2007
Last updated
04/19/2008
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