Individual
DR. JEFFREY GLENN JERUSS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
O.D.
Contact information
Practice address
2255 SEWELL MILL RD, SUITE 310, MARIETTA, GA 30062-2804
(770) 578-1900
(770) 578-6623
Mailing address
2255 SEWELL MILL RD, SUITE 310, MARIETTA, GA 30062-2804
(770) 578-1900
(770) 578-6623
Taxonomy
Speciality
Code
Description
License number
State
152W00000X
Optometrist
Primary
OPT001332
GA
152WC0802X
Corneal and Contact Management Optometrist
OPT001332
GA
152WV0400X
Vision Therapy Optometrist
OPT001332
GA
Other
Enumeration date
10/24/2007
Last updated
11/21/2008
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