Individual
JESSE AUSTIN LAM
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
OD
Contact information
Practice address
13371 W GRAND AVE STE 102, SURPRISE, AZ 85374-7063
(623) 556-8083
Mailing address
7234 W KIMBERLY WAY, GLENDALE, AZ 85308-5857
(623) 628-6841
Taxonomy
Speciality
Code
Description
License number
State
152W00000X
Optometrist
Primary
002430
AZ
Other
Enumeration date
06/15/2020
Last updated
06/15/2020
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