Individual
DAVID DEJESUS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
OPTICIAN
Contact information
Practice address
2826 E HARBOR RD, PORT CLINTON, OH 43452-2611
(419) 734-7995
(419) 734-7995
Mailing address
2826 E HARBOR RD, PORT CLINTON, OH 43452-2611
(419) 734-7995
Taxonomy
Speciality
Code
Description
License number
State
156FX1800X
Optician
Primary
6109SC
OH
Other
Enumeration date
03/03/2023
Last updated
03/03/2023
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