Individual
GARY E ROQUEMORE
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
OD
Contact information
Practice address
904 HIGHWAY 78 E, JASPER, AL 35501-3957
(205) 221-6718
(205) 221-7578
Mailing address
904 HIGHWAY 78 E, JASPER, AL 35501-3957
(205) 221-6718
(205) 221-7578
Taxonomy
Speciality
Code
Description
License number
State
152W00000X
Optometrist
Primary
S438TA078
AL
Other
Enumeration date
10/07/2005
Last updated
06/25/2010
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