Jeffrey Reisch
Optometrist in Coral Springs, FL. Individual provider (NPI-1).
NPI number1104907484
StatusActive
Last updated in NPPESJul 8, 2007
Details
- NPI
- 1104907484
- Entity type
- Individual (NPI-1)
- Name
- Jeffrey Reisch
- Sex
- Male
- Sole proprietor
- No
- Enumeration date
- Oct 17, 2006
- Last updated
- Jul 8, 2007
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 152W00000X | Optometrist | OPC 1610 | FL | Yes |
Practice location
2059 N University DrCoral Springs, FL 33071-6132
Phone 954-752-0589 · Fax 954-753-1101
Mailing address
10866 Nw 6th StCoral Springs, FL 33071-7940
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