Individual
ELIZABETH GAY NORDTVEDT
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
O.D.
Contact information
Practice address
112 STONEBRIDGE BLVD, JACKSON, TN 38305-2038
(731) 664-1994
Mailing address
18 MILLVIEW CV, JACKSON, TN 38305-8593
Taxonomy
Speciality
Code
Description
License number
State
152W00000X
Optometrist
Primary
2800
TN
Other
Enumeration date
07/08/2008
Last updated
09/05/2011
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