Organization
JENNETT M DOHERTY COMPLETE OPTICAL
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MRS. JENNETT M DOHERTY (OWNER LICENSED DISPENSING OPTICIAN)
(901) 761-4292
Entity
Organization
Contact information
Practice address
6238 POPLAR AVE, MEMPHIS, TN 38119-4713
(901) 761-4292
(901) 761-7805
Mailing address
6238 POPLAR AVE, MEMPHIS, TN 38119-4713
(901) 761-4292
(901) 761-7805
Taxonomy
Speciality
Code
Description
License number
State
152W00000X
Optometrist
Primary
OPC325
TN
Other
Enumeration date
03/25/2008
Last updated
09/24/2008
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