Individual
MR. JUBAL S PILLEN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
OPTICIAN
Contact information
Practice address
1020 JUNCTION AVE, STURGIS, SD 57785-1632
(605) 347-9117
(605) 347-8652
Mailing address
1020 JUNCTION AVE, STURGIS, SD 57785-1632
(605) 347-9117
(605) 347-8652
Taxonomy
Speciality
Code
Description
License number
State
156FX1800X
Optician
Primary
NA
SD
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
9203230
—
SD
Enumeration date
12/01/2006
Last updated
07/08/2007
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