Individual
DR. JACK LYNN NEELY
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
OD
Contact information
Practice address
1010 N 21ST ST, NEWARK, OH 43055-2922
(740) 366-5050
(740) 366-4149
Mailing address
1010 N 21ST ST, NEWARK, OH 43055-2922
(740) 366-5050
(740) 366-4149
Taxonomy
Speciality
Code
Description
License number
State
152W00000X
Optometrist
Primary
3191T955
OH
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0275287
—
OH
Enumeration date
02/02/2006
Last updated
08/16/2010
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