Individual
MR. JEFFERY M ICEBERG
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
OD
Contact information
Practice address
3192 S LINDEN RD, SUITE B121, FLINT, MI 48507
(810) 230-9300
(810) 230-1453
Mailing address
140 MACOMB, MT CLEMENS, MI 48043
(586) 468-7370
(586) 464-1472
Taxonomy
Speciality
Code
Description
License number
State
152W00000X
Optometrist
Primary
4901003330
MI
Other
Enumeration date
01/25/2007
Last updated
07/08/2007
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