Individual
TREV DIDELOT
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
OD
Contact information
Practice address
8010 OAK PARK RD NE, NEW SALISBURY, IN 47161-8401
(812) 366-3147
Mailing address
1028 SCHROEDER AVE, JASPER, IN 47546-3743
(812) 639-8988
Taxonomy
Speciality
Code
Description
License number
State
152W00000X
Optometrist
Primary
18004509A
IN
Other
Enumeration date
06/18/2024
Last updated
06/18/2024
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