NPI 1326148933

Jay D Petersma, OD

Practitioner Optometrist Johnston, IA

Practice location

Address: 5501 NW 86th St Suite 500, Johnston, IA 50131-1816
Phone: (515) 270-0494
Fax: (515) 270-6463

Registered specialties (2)

Optometrist Primary

Eye and Vision Services Providers Taxonomy 152W00000X Licence 01861 (IA)

Other Optometrist providers in Iowa →

Corneal and Contact Management Optometrist

Eye and Vision Services Providers Taxonomy 152WC0802X Licence 01861 (IA)

Registry record

NPI: 1326148933
Entity type: Individual
Sex (as registered): Male
NPI issued: 24 Sep 2006
Record last updated: 11 Jan 2010

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.