Individual
JENNA VERGELDT
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
OD
Contact information
Practice address
921 NE 13TH ST, OKLAHOMA CITY, OK 73104-5007
(405) 456-4017
Mailing address
2034 TOWN ROAD 492, INTERNATIONAL FALLS, MN 56649-8707
(218) 417-0739
Taxonomy
Speciality
Code
Description
License number
State
152W00000X
Optometrist
Primary
10401T
TX
Other
Enumeration date
02/06/2020
Last updated
07/28/2022
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