Organization
JACOB G. DESPAIN OD PC
Active
Other names
Family Vision Clinic
Organization subpart
No
Provider details
NPI number
Authorized official
JACOB G DESPAIN O.D. (OPTOMETRIST)
(307) 587-2404
Entity
Organization
Contact information
Practice address
426 NEVADA AVE, LOVELL, WY 82431-1916
(307) 548-7450
(307) 548-7596
Mailing address
426 NEVADA AVE, LOVELL, WY 82431-1916
(307) 548-7450
(307) 548-7596
Taxonomy
Speciality
Code
Description
License number
State
152W00000X
Optometrist
Primary
327T
WY
Other
Enumeration date
05/19/2014
Last updated
05/19/2014
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