Individual
GREGORY PAUL JELLENEK
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
O.D.
Contact information
Practice address
BLDG. 1527, FT. EUSTIS, VA 23604-1618
(757) 887-3627
(757) 887-0403
Mailing address
5251-18 JOHN TYLER HWY., #353, WILLIAMSBURG, VA 23185-8808
(757) 963-1863
(757) 963-1881
Taxonomy
Speciality
Code
Description
License number
State
152W00000X
Optometrist
Primary
0618000342
VA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
010045711
—
VA
Enumeration date
07/06/2006
Last updated
05/23/2011
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