Riley C Juenemann, OD | |
2043 Greystone Sq, Jackson, TN 38305-3576 | |
(573) 579-4809 | |
Not Available |
Full Name | Riley C Juenemann |
---|---|
Gender | Male |
Speciality | Optometrist |
Location | 2043 Greystone Sq, Jackson, Tennessee |
Accepts Medicare Assignments | Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs. |
Identifier | Type | State | Issuer |
---|---|---|---|
1184363640 | NPI | - | NPPES |
3745 | Other | TN | STATE LICENSE |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
152W00000X | Optometrist | 3745 (Tennessee) | Primary |
Provider Name | Tennessee Vision Partners Pllc |
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Provider Type | Part B Supplier - Other |
Provider Identifiers | NPI Number: 1902317381 PECOS PAC ID: 7618237611 Enrollment ID: O20180213001943 |
Mailing Address | Practice Location Address |
---|---|
Riley C Juenemann, OD 2043 Greystone Sq, Jackson, TN 38305-3576 Ph: (573) 579-4809 | Riley C Juenemann, OD 2043 Greystone Sq, Jackson, TN 38305-3576 Ph: (573) 579-4809 |
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