Jeremy Wade Anderson OD

NPI 1063405256 - Optometrist - 152W00000X

NPI Details
NPI 1063405256
Gender Male
Enumeration Date 08/24/2005
Last Updated 01/14/2013
Entity Type Individual
Active Over 11 years ago
Practice Location
1642 MCARTHUR ST
MANCHESTER TN, 37355-2522, US
Phone (931) 728-1315
Fax (931) 728-1779
Business Location
1642 MCARTHUR ST
MANCHESTER TN, 37355-2522, US
Phone (931) 728-1315
Fax (931) 728-1779
Toxanomy
Taxonomy Code 152W00000X
License State Tennessee
License Number 2431
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According to our database, Dr. Jeremy Wade Anderson OD NPI is 1063405256, taxonomy code is 152W00000X and license number is 2431, license state is located at Tennessee. Jeremy Wade Anderson OD physically located at 1642 Mcarthur St, Manchester TN, 37355-2522. NPI Number Jeremy Wade Anderson OD has the Individual type.

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1063405256 NPI number is provided on an as is basis without warranty of any kind. 1063405256 is maintained by the National Plan & Provider Enumeration System. The contents of Jeremy Wade Anderson OD are for informational purposes only.