Organization
JENNIFER M GUDAS OD, PC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. JENNIFER M GUDAS OD (OPTOMETRIST)
(574) 946-3944
Entity
Organization
Contact information
Practice address
633 E 13TH ST, WINAMAC, IN 46996-1157
(574) 946-3944
(574) 946-6843
Mailing address
633 E 13TH ST, PO BOX 365, WINAMAC, IN 46996-1157
(574) 946-3944
(574) 946-6843
Taxonomy
Speciality
Code
Description
License number
State
152W00000X
Optometrist
Primary
18003318B
IN
152WC0802X
Corneal and Contact Management Optometrist
18003318B
IN
152WP0200X
Pediatric Optometrist
18003318B
IN
332H00000X
Eyewear Supplier
18003318B
IN
Other
Enumeration date
12/14/2011
Last updated
12/25/2011
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