Individual
MRS. KIMBERLY S JEPSON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
OPTICIAN
Contact information
Practice address
4421 MAIN AVE, ASHTABULA, OH 44004-6922
(440) 998-4720
(440) 998-4720
Mailing address
4421 MAIN AVE, ASHTABULA, OH 44004-6922
(440) 998-4720
(440) 998-4720
Taxonomy
Speciality
Code
Description
License number
State
156FX1800X
Optician
Primary
4919-S
OH
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
2579286
—
OH
Enumeration date
03/23/2006
Last updated
12/11/2008
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