Individual
JERRY R HENSEL
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
OD
Contact information
Practice address
137 JPM RD, LEWISBURG, PA 17837-9313
(570) 523-3937
Mailing address
96 SWEET GUM ROAD, SELINSGROVE, PA 17870
(570) 374-7904
Taxonomy
Speciality
Code
Description
License number
State
152W00000X
Optometrist
Primary
OEG001747
PA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
001563915
—
PA
01
—
50045022
CAPITAL BLUE
PA
01
—
536441
AETNA
PA
01
—
831613
BLUE SHIELD
PA
Enumeration date
10/06/2006
Last updated
01/13/2021
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