NPI 1619092574

Kelli Jackson

Organisation Optometrist Cleveland, TN

Practice location

Address: 114 Stuart Rd NE #102, Cleveland, TN 37312-4803
Phone: (252) 985-1371
Mailing address: PO Box 7396, Rocky Mount, NC 27804-0396

Authorised official

Name: Kelli J Jackson
Title: Optometrist
Phone: (252) 985-1371

Registered specialties

Optometrist Primary

Eye and Vision Services Providers Taxonomy 152W00000X Licence 1566 (TN)

Other Optometrist providers in Tennessee →

Registry record

NPI: 1619092574
Entity type: Organization
NPI issued: 20 Mar 2007
Record last updated: 3 Jul 2008

Reproduced from NPPES, the federal provider registry. The date above is when the provider last updated their own entry, not when we fetched it - a record can be years old and still current in the registry.