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Organization

OLD TOWN OPTOMETRY INC

Active
Organization subpart
No

Provider details

NPI number
Authorized official
DR. RONALD OWEN JENSEN OD (CEO)
(760) 771-0715
Entity
Organization

Contact information

Practice address
78015 MAIN ST STE 107, LA QUINTA, CA 92253-3420
(760) 771-0715
(760) 771-2033
Mailing address
78015 MAIN ST STE 107, LA QUINTA, CA 92253-3420
(760) 771-0715

Taxonomy

Speciality
Code
Description
License number
State
152WC0802X
Corneal and Contact Management Optometrist
Primary

Other

Enumeration date
07/16/2013
Last updated
07/16/2013
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