person
Mr. Jimmie Tantillo Phelps, PSC
Optician in Richmond, Kentucky
NPI 1740440742

Jimmie Tantillo Phelps is a Optician based in Richmond, KY and is specialized in Optician. Jimmie Tantillo Phelps practices in Richmond, KY and has the professional credentials of PSC. The NPI Number for Jimmie Tantillo Phelps is 1740440742 and holds a License No. 325 (Kentucky).

The current practice location address for Jimmie Tantillo Phelps is 205 Geri Ln, Richmond, KY and can be reached out via phone at 859-623-4267 and via fax at 859-623-4249. You can also correspond with Jimmie Tantillo Phelps through the mailing address at 205 GERI LN, RICHMOND, KY - 40475-2359 (mailing address contact number: 859-623-4267).

Location: 205 Geri Ln, Richmond, KY, 40475-2359
person
Provider Profile Details
NPI Number
1740440742
Provider Name
Jimmie Tantillo Phelps
Credential
PSC
Provider Entity Type
Individual
Gender
Male
Address
205 Geri Ln, Richmond, KY, 40475-2359
Phone Number
859-623-4267
Fax Number
859-623-4249
Provider Enumeration Date
06/12/2008
Last Update Date
03/09/2024
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Provider's Legacy Identifiers
Identifier Type State Issuer
52800919 05 KY
OP0933 01 KY EYE MED
institution
Provider Business Practice Location Address Details
Address
205 Geri Ln
City
State
Zip
40475-2359
Phone Number
859-623-4267
Fax Number
859-623-4249
person
Provider Business Mailing Address Details
Address
205 Geri Ln
City
State
Zip
40475-2359
Phone Number
859-623-4267
Fax Number
859-623-4249
person
Provider's Taxonomy Details 1
Type
Eye and Vision Services Providers
Classification
Technician/Technologist
Speciality
Optician
Taxonomy
License No.
325 (Kentucky)
Definition
Definition to come...
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