Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 152W00000X | Optometrist | 3353 | OH |
NPI | 1013068766 |
---|---|
Provider Name | Jan Charles Huneke |
First Address | Cincinnati, OH 45255-4504 |
Second Address | Cincinnati, OH 45245-1535 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 16/01/2007 |
Last Update Date | 08/07/2007 |