| NPI | 1497889067 |
|---|---|
| Former Name | JACQUELYN M. WERT |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 152W00000X Optometrist (Licence: OR 3024ATI) |
| Additional Taxonomies | 152WV0400X Optometrist, Vision Therapy (Licence: OR 3024ATI) |
| 152WP0200X Optometrist, Pediatrics (Licence: OR 3024ATI) | |
| Enumeration Date | 2007-03-15 |
| Last Update Date | 2010-10-12 |