Individual
JONATHAN LAM
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
OD
Contact information
Practice address
500 N US HIGHWAY 89, PRESCOTT, AZ 86313-5001
(928) 717-7477
Mailing address
500 N US HIGHWAY 89, PRESCOTT, AZ 86313-5001
(928) 717-7477
Taxonomy
Speciality
Code
Description
License number
State
152W00000X
Optometrist
Primary
0618002879
VA
Other
Enumeration date
04/16/2020
Last updated
09/27/2024
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