Individual
DR. PETER O IM
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
O.D.
Contact information
Practice address
2080 CHILD ST, JACKSONVILLE, FL 32214-5005
(904) 542-7194
Mailing address
3475 N SARATOGA ST, OAK HARBOR, WA 98278-4927
(360) 257-9600
Taxonomy
Speciality
Code
Description
License number
State
152W00000X
Optometrist
Primary
11597T
CA
152W00000X
Optometrist
2912AT
OR
152W00000X
Optometrist
3677
WA
Other
Enumeration date
01/25/2006
Last updated
02/27/2019
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