Individual
JASON LEE ERVIN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
4490 GALLIA ST, NEW BOSTON, OH 45662-5553
(740) 456-8650
(740) 456-8652
Mailing address
4490 GALLIA ST, NEW BOSTON, OH 45662-5553
(740) 456-8650
(740) 456-8652
Taxonomy
Speciality
Code
Description
License number
State
156FX1800X
Optician
Primary
OP.006432-SC
OH
Other
Enumeration date
02/10/2023
Last updated
02/10/2023
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