Individual
SAMANTHA NICHOLE JAHNKE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
OD
Contact information
Practice address
2852 E 3RD ST, BLOOMINGTON, IN 47401-5423
(812) 334-1893
Mailing address
2852 E 3RD ST, BLOOMINGTON, IN 47401-5423
Taxonomy
Speciality
Code
Description
License number
State
152W00000X
Optometrist
Primary
18003798A
IN
Other
Enumeration date
06/18/2013
Last updated
12/19/2013
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