Individual
JASON PORTER MERRELL
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
OD
Contact information
Practice address
1606 S SIGNAL BUTTE RD, MESA, AZ 85209-1482
(480) 358-9737
Mailing address
1661 E LUNA BLANCA WAY, SAN TAN VALLEY, AZ 85140-8466
(208) 390-0826
Taxonomy
Speciality
Code
Description
License number
State
152W00000X
Optometrist
ODP-100409
ID
152W00000X
Optometrist
Primary
OPT-002328
AZ
Other
Enumeration date
06/14/2017
Last updated
11/02/2021
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