| NPI | 1215247184 |
|---|---|
| Doing Business As | JACOB HISCOX, OD |
| Entity Type | Organization |
| Authorized Contact | JACOB WYLEY HISCOX Member 520-885-2052 |
| Organization Subpart ? | No |
| Primary Taxonomy | 152W00000X Optometrist (Licence: AZ 1643) |
| Enumeration Date | 2010-10-13 |
| Last Update Date | 2022-03-11 |