Individual
JONATHAN MICHAEL KLUNK
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
OD
Contact information
Practice address
1819 HOMER ADAMS PKWY, ALTON, IL 62002-5606
(618) 208-0585
(618) 208-0586
Mailing address
PO BOX 207163, DALLAS, TX 75320-7163
(636) 200-4393
(636) 527-0766
Taxonomy
Speciality
Code
Description
License number
State
152W00000X
Optometrist
Primary
046.011750
IL
390200000X
Student in an Organized Health Care Education/Training Program
—
—
Other
Enumeration date
03/03/2023
Last updated
12/21/2023
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