Provider Demographics
NPI:1073058731
Name:FORSCH, JESSICA (OD)
Entity Type:Individual
Prefix:
First Name:JESSICA
Middle Name:
Last Name:FORSCH
Suffix:
Gender:F
Credentials:OD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:100 BROOKSHIRE BLVD
Mailing Address - Street 2:BLDG 2, STE 2
Mailing Address - City:BILLINGS
Mailing Address - State:MT
Mailing Address - Zip Code:59102-6751
Mailing Address - Country:US
Mailing Address - Phone:406-656-8886
Mailing Address - Fax:406-655-9691
Practice Address - Street 1:2675 CENTRAL AVE
Practice Address - Street 2:SUITE L-1
Practice Address - City:BILLINGS
Practice Address - State:MT
Practice Address - Zip Code:59102-6686
Practice Address - Country:US
Practice Address - Phone:406-656-8886
Practice Address - Fax:406-655-9691
Is Sole Proprietor?:Yes
Enumeration Date:2017-01-04
Last Update Date:2017-02-06
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
MT2806152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152W00000XEye and Vision Services ProvidersOptometrist