Individual
JILLIAN PENNEY
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
OD
Contact information
Practice address
1201 W ELM AVE, HANOVER, PA 17331-4600
(717) 630-2922
Mailing address
14 BEACHFIELD LN, HANOVER, PA 17331-3552
(570) 262-5627
Taxonomy
Speciality
Code
Description
License number
State
152W00000X
Optometrist
Primary
OEG003722
PA
390200000X
Student in an Organized Health Care Education/Training Program
—
—
Other
Enumeration date
05/20/2020
Last updated
08/31/2020
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