Individual
JESSICA LIPTAK
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
9303 MENTOR AVE, MENTOR, OH 44060-6413
(440) 974-3303
Mailing address
9303 MENTOR AVE, MENTOR, OH 44060-6413
Taxonomy
Speciality
Code
Description
License number
State
156FX1800X
Optician
Primary
017651
OH
Other
Enumeration date
10/11/2023
Last updated
10/11/2023
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