Individual
JONATHAN P ANDERSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
OD
Contact information
Practice address
225 W ASHLAND, STE 1, INDIANOLA, IA 50125
(515) 961-5305
(515) 961-9225
Mailing address
225 W ASHLAND AVE, STE 1, INDIANOLA, IA 50125-2462
(515) 961-5305
(515) 961-9225
Taxonomy
Speciality
Code
Description
License number
State
152W00000X
Optometrist
Primary
02145
IA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0278069
—
IA
05
—
1278069
—
IA
05
—
2278069
—
IA
Enumeration date
05/15/2006
Last updated
02/04/2014
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