Individual
MS. JENNIFER SUZANNE PURDY
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
OPTICIAN
Contact information
Practice address
25340 W NEWBERRY RD, NEWBERRY, FL 32669-4252
(352) 474-6555
Mailing address
25340 W NEWBERRY RD, NEWBERRY, FL 32669-4252
Taxonomy
Speciality
Code
Description
License number
State
156FX1800X
Optician
Primary
6180
FL
Other
Enumeration date
09/24/2012
Last updated
09/24/2012
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