Organization
JAY D PETERSMA OD PC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. JAY D PETERSMA O.D. (PRESIDENT)
(515) 270-0494
Entity
Organization
Contact information
Practice address
5501 NW 86TH ST, STE 500, JOHNSTON, IA 50131-1816
(515) 270-0494
Mailing address
5501 NW 86TH ST, STE 500, JOHNSTON, IA 50131-1816
(515) 270-0494
Taxonomy
Speciality
Code
Description
License number
State
152W00000X
Optometrist
Primary
01861
IA
Other
Enumeration date
10/04/2012
Last updated
10/04/2012
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