Individual
JASON P NOLZ
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
O.D.
Contact information
Practice address
208 W DL INGRAM AVE, CANNON AFB, NM 88103-5014
(575) 784-6608
Mailing address
208 W DL INGRAM AVE, CANNON AFB, CLOVIS, NM 88103-5014
(575) 784-6608
Taxonomy
Speciality
Code
Description
License number
State
152W00000X
Optometrist
2180
CO
152W00000X
Optometrist
Primary
627
MT
Other
Enumeration date
07/28/2006
Last updated
10/02/2014
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