Most Relevant Information
Provider Data
| NPI Number: | 1003800012 |
| Provider Name: | JONATHAN GLYNDON KNUTSON OD |
| Entity Type: | Individual |
| Taxonomy Code: | 152W00000X |
| Specialty: | Optometrist |
| License Number: | 1147 |
Most Important Dates
| Enumeration Date: | 09/06/2005 |
| Last Updated: | 07/20/2007 |
Provider Practice Location
5630 S 84TH ST
SUITE 120
LINCOLN
NE
685164427
Practice Location Phone/Fax
| Phone: | 4024882211 |
| Fax: |
Provider Mailing Location
5630 S 84TH ST
SUITE 120
LINCOLN
NE
685164427
Provider Mailing Phone/Fax
| Phone: | 4024882211 |
| Fax: |