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Individual

MRS. JANN M FUGELSETH

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F
Credential
OPTICIAN

Contact information

Practice address
1404 GEKELER LN, LA GRANDE, OR 97850-3368
(541) 962-1025
(541) 963-2455
Mailing address
1404 GEKELER LN, LA GRANDE, OR 97850-3368
(541) 962-1025
(541) 963-2455

Taxonomy

Speciality
Code
Description
License number
State
156FX1800X
Optician
Primary

Other

Enumeration date
01/17/2008
Last updated
06/03/2008
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