Jay Wilfred Mauck, OD

NPI #1184608325 in The Dalles, Oregon

Provider Information

NPI Number: 1184608325
Entity Type: Individual
Name: Jay Wilfred Mauck, OD
Gender: Not Specified
Sole Proprietor: No
Primary Specialty: Optometrist
Credential: OD
Enumeration Date: Dec 1, 2005
Last Updated: Nov 16, 2007

Practice Location

Address: 415 WASHINGTON ST
City: The Dalles
State: Oregon
ZIP Code: 97058-2215
Phone: (541) 296-2911

Specialties & Taxonomy Codes

Specialty	Taxonomy Code	Primary
Optometrist	152W00000X	Primary

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