Organization
GLORIA C JENNINGS OD, PROFESSIONAL CORPORATION
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. GLORIA C JENNINGS O.D. (OPTOMETRIST)
(317) 876-1112
Entity
Organization
Contact information
Practice address
1717 W 86TH ST, SUITE 130, INDIANAPOLIS, IN 46260-2050
(317) 876-1112
(317) 876-2187
Mailing address
1717 W 86TH ST, SUITE 130, INDIANAPOLIS, IN 46260-2050
(317) 876-1112
(317) 876-2187
Taxonomy
Speciality
Code
Description
License number
State
152W00000X
Optometrist
Primary
18001957
IN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
100239200
—
IN
Enumeration date
07/23/2009
Last updated
09/05/2013
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