Organization
ON-SITE MEDICAL PROVIDERS
Active
Organization subpart
No
Provider details
NPI number
Authorized official
JENNIFER REYES (PRESIDENT)
(210) 722-2963
Entity
Organization
Contact information
Practice address
6928 BAYOU GEORGE DR, PANAMA CITY, FL 32404-5013
(210) 722-2963
Mailing address
6928 BAYOU GEORGE DR, PANAMA CITY, FL 32404-5013
(210) 722-2963
Taxonomy
Speciality
Code
Description
License number
State
152W00000X
Optometrist
Primary
—
—
Other
Enumeration date
02/03/2018
Last updated
02/03/2018
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