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Individual

JACOB HEATH

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
O.D.

Contact information

Practice address
1207 N ONE MILE RD, DEXTER, MO 63841-1041
(573) 624-4584
(573) 624-4992
Mailing address
1200 W DEYOUNG ST, MARION, IL 62959-4437
(618) 993-5686
(618) 997-6250

Taxonomy

Speciality
Code
Description
License number
State
152W00000X
Optometrist
Primary
2016023867
MO

Other

Enumeration date
07/21/2016
Last updated
04/03/2026
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