Jacob Hannon

NPI #1124388525 in Cody, Wyoming

Provider Information

NPI Number: 1124388525
Entity Type: Individual
Name: Jacob Hannon
Gender: Not Specified
Sole Proprietor: Yes
Primary Specialty: Optometrist
Enumeration Date: May 21, 2012
Last Updated: Mar 30, 2016

Practice Location

Address: 2814 KENT AVE
City: Cody
State: Wyoming
ZIP Code: 82414-8250
Phone: (307) 272-2716

Specialties & Taxonomy Codes

Specialty	Taxonomy Code	Primary
Student in an Organized Health Care Education/Training Program	390200000X
Optometrist	152W00000X	Primary

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