Organization
JEAN PAUL ETIENNE, OD, PC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. JEAN PAUL ETIENNE OD (PRESIDENT)
(812) 345-1850
Entity
Organization
Contact information
Practice address
3024 E 3RD ST, BLOOMINGTON, IN 47401-5425
(812) 330-2900
Mailing address
729 N KEYSTONE CT, BLOOMINGTON, IN 47408-2800
(812) 345-1850
(866) 670-7077
Taxonomy
Speciality
Code
Description
License number
State
152W00000X
Optometrist
Primary
18003348B
IN
Other
Enumeration date
04/28/2011
Last updated
04/28/2011
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