Organization
J & K OPTICAL, INC.
Active
Other names
Pearle Vision
Organization subpart
No
Provider details
NPI number
Authorized official
DR. JACK HAULER O.D. (OWNER)
(610) 896-0610
Entity
Organization
Contact information
Practice address
74 COULTER AVE, ARDMORE, PA 19003-2308
(610) 896-0610
Mailing address
74 COULTER AVE, ARDMORE, PA 19003-2308
(610) 896-0610
Taxonomy
Speciality
Code
Description
License number
State
332B00000X
Durable Medical Equipment & Medical Supplies
Primary
6000001626
PA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
205866
PA BLUE CHIELD
PA
Enumeration date
03/05/2007
Last updated
01/12/2009
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