Individual
JONATHAN VANGESSEL
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
OD
Contact information
Practice address
1752 E MARKET ST, NAPPANEE, IN 46550-9216
(574) 773-4341
Mailing address
11520 E 300 N, AVILLA, IN 46710-9636
(260) 242-1310
Taxonomy
Speciality
Code
Description
License number
State
152W00000X
Optometrist
Primary
18004161A
IN
Other
Enumeration date
06/13/2019
Last updated
06/13/2019
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