Individual
JARETT A MAZZARELLA
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
OD
Contact information
Practice address
1601 BRENNER AVE, 11-1 (OPTOMETRY SERVICE), SALISBURY, NC 28144-2515
(814) 241-6519
Mailing address
1601 BRENNER AVE, 11-1 (OPTOMETRY SERVICE), SALISBURY, NC 28144-2515
(814) 241-6519
Taxonomy
Speciality
Code
Description
License number
State
152W00000X
Optometrist
Primary
2002
NC
152W00000X
Optometrist
OEG001701
PA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
5904113
—
NC
Enumeration date
06/19/2006
Last updated
06/10/2014
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