Organization
PULASKI EYE CARE, INC.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. JASON ANTHONY FORT OD (PRESIDENT)
(629) 235-4230
Entity
Organization
Contact information
Practice address
1125 E COLLEGE ST, PULASKI, TN 38478-4520
(931) 363-4557
Mailing address
1125 E COLLEGE ST, PULASKI, TN 38478-4520
(931) 363-4557
Taxonomy
Speciality
Code
Description
License number
State
152W00000X
Optometrist
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1427088178
—
TN
05
—
Q052848
—
TN
Enumeration date
08/11/2021
Last updated
08/11/2021
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