Individual
CHARLES A. JESSUP
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
O.D.
Contact information
Practice address
4000 LITTLE BLUE PKWY, INDEPENDENCE, MO 64057-8309
(816) 795-1122
Mailing address
8857 W 75TH ST, OVERLAND PARK, KS 66204-2206
(913) 362-8822
(913) 677-2477
Taxonomy
Speciality
Code
Description
License number
State
152W00000X
Optometrist
Primary
T02195
MO
Other
Enumeration date
07/27/2006
Last updated
07/08/2007
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