Individual
JERRY ALBERT BARCELOW
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
1593 VT RTE 107, BETHEL, VT 05032-4456
(802) 234-9728
(802) 234-9732
Mailing address
1593 VT RTE 107, BETHEL, VT 05032-4456
(802) 234-9728
(802) 234-9732
Taxonomy
Speciality
Code
Description
License number
State
152W00000X
Optometrist
Primary
300000196
VT
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0006624
—
VT
Enumeration date
08/13/2006
Last updated
12/11/2014
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