Individual
JENNY LA
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
3601 S 6TH AVE # 11-112A, TUCSON, AZ 85723-0001
(520) 792-1450
Mailing address
3061 S JOSHUA TREE LN, GILBERT, AZ 85295-2769
Taxonomy
Speciality
Code
Description
License number
State
152W00000X
Optometrist
Primary
OPT-002442
AZ
390200000X
Student in an Organized Health Care Education/Training Program
—
—
Other
Enumeration date
03/24/2020
Last updated
07/20/2021
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