Individual
JERALD T JOLLEY
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
O.D.
Contact information
Practice address
635 E 400 S, SALT LAKE CITY, UT 84102-2803
(801) 531-7513
(801) 257-0399
Mailing address
11103 WEST AVE, SUITE 6, SAN ANTONIO, TX 78213-1370
(210) 524-6663
(210) 524-6587
Taxonomy
Speciality
Code
Description
License number
State
152W00000X
Optometrist
Primary
2774059934
UT
Other
Enumeration date
06/29/2006
Last updated
07/08/2007
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