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Individual

SANDRA K JONES

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
OD

Contact information

Practice address
7200 MENTOR AVE, MENTOR, OH 44060-7522
(440) 946-8809
(440) 269-7942
Mailing address
211 E BROADWAY, ALTON, IL 62002-6220
(618) 462-9818
(314) 741-4947

Taxonomy

Speciality
Code
Description
License number
State
152W00000X
Optometrist
1903
SC
152W00000X
Optometrist
Primary
OPT.006551
OH
152W00000X
Optometrist
OPT002911
GA

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
D19036
SC
Enumeration date
07/20/2011
Last updated
05/12/2021
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