Individual
DR. JONATHAN GLYNDON KNUTSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
OD
Contact information
Practice address
5630 S 84TH ST, SUITE 120, LINCOLN, NE 68516-4427
(402) 488-2211
Mailing address
5630 S 84TH ST, SUITE 120, LINCOLN, NE 68516-4427
(402) 488-2211
Taxonomy
Speciality
Code
Description
License number
State
152W00000X
Optometrist
Primary
1147
NE
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
36755
BCBS
NE
Enumeration date
09/06/2005
Last updated
07/20/2007
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