Jeffery M Iceberg OD

NPI 1356497432 - Optometrist - 152W00000X

NPI Details
NPI 1356497432
Gender Male
Enumeration Date 01/25/2007
Last Updated 07/08/2007
Entity Type Individual
Active Over 9 years ago
Practice Location
3192 S LINDEN RD
SUITE B121
FLINT MI, 48507, US
Phone (810) 230-9300
Fax (810) 230-1453
Business Location
140 MACOMB
MT CLEMENS MI, 48043, US
Phone (586) 468-7370
Fax (586) 464-1472
Toxanomy
Taxonomy Code 152W00000X
License State Michigan
License Number 4901003330
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According to our database, Mr. Jeffery M Iceberg OD NPI is 1356497432, taxonomy code is 152W00000X and license number is 4901003330, license state is located at Michigan. Jeffery M Iceberg OD physically located at 3192 S Linden Rd, Flint MI, 48507. NPI Number Jeffery M Iceberg OD has the Individual type.

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1356497432 NPI number is provided on an as is basis without warranty of any kind. 1356497432 is maintained by the National Plan & Provider Enumeration System. The contents of Jeffery M Iceberg OD are for informational purposes only.