Individual
DR. JENNET RUTH SHEPHERD
Active
Sole proprietor
Provider details
NPI number
Gender
F
Credential
O.D.
Contact information
Practice address
2500 E US HIGHWAY 14, JANESVILLE, WI 53545-0309
(608) 754-7411
Mailing address
PO BOX 833, 2500 US HWY 14, JANESVILLE, WI 53547-0833
(608) 754-7411
Taxonomy
Speciality
Code
Description
License number
State
152W00000X
Optometrist
Primary
2870-035
WI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
38613900
—
WI
Enumeration date
05/16/2006
Last updated
07/08/2007
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