Individual
JENNIFER R MCINTYRE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
O.D.
Contact information
Practice address
9737 GILES RD, LAVISTA, NE 68128-2930
(402) 963-0831
(402) 597-0330
Mailing address
9737 GILES RD, LAVISTA, NE 68128-2930
(402) 963-0831
(402) 597-0330
Taxonomy
Speciality
Code
Description
License number
State
152W00000X
Optometrist
Primary
1112
NE
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
06803
BCBS
NE
Enumeration date
03/09/2007
Last updated
07/08/2007
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