Gillette Optometric Clinic PC

NPI #1891850707 in Gillette, Wyoming

Provider Information

NPI Number: 1891850707
Entity Type: Organization
Organization Name: Gillette Optometric Clinic PC
Primary Specialty: Optometrist
Enumeration Date: Dec 22, 2006
Last Updated: Apr 13, 2010

Practice Location

Address: 609 4J CT
City: Gillette
State: Wyoming
ZIP Code: 82716-4135
Phone: (307) 682-2020

Authorized Official

Name: DR. ROGER L JORDAN, O.D.
Title: PRESIDENT
Phone: (307) 682-2020

Specialties & Taxonomy Codes

Specialty	Taxonomy Code	Primary
Optometrist	152W00000X	Primary
Optometrist - Corneal and Contact Management — Corneal and Contact Management	152WC0802X
Optometrist - Vision Therapy — Vision Therapy	152WV0400X

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