Jacob G. Despain Od PC

NPI #1326459835 in Lovell, Wyoming

Provider Information

NPI Number: 1326459835
Entity Type: Organization
Organization Name: Jacob G. Despain Od PC
Primary Specialty: Optometrist
Enumeration Date: May 19, 2014
Last Updated: May 19, 2014

Practice Location

Address: 426 NEVADA AVE
City: Lovell
State: Wyoming
ZIP Code: 82431-1916
Phone: (307) 548-7450

Authorized Official

Name: JACOB G DESPAIN, O.D.
Title: OPTOMETRIST
Phone: (307) 587-2404

Specialties & Taxonomy Codes

Specialty	Taxonomy Code	Primary
Optometrist	152W00000X	Primary

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