Provider Demographics
NPI:1346935269
Name:JAEGER-GARCIA, BRICE
Entity Type:Individual
Prefix:
First Name:BRICE
Middle Name:
Last Name:JAEGER-GARCIA
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:BRICE
Other - Middle Name:
Other - Last Name:JAEGER
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:
Mailing Address - Street 1:5200 WESTPOINTE PLAZA DR
Mailing Address - Street 2:
Mailing Address - City:COLUMBUS
Mailing Address - State:OH
Mailing Address - Zip Code:43228-9126
Mailing Address - Country:US
Mailing Address - Phone:614-876-6747
Mailing Address - Fax:614-876-6311
Practice Address - Street 1:5200 WESTPOINTE PLAZA DR
Practice Address - Street 2:
Practice Address - City:COLUMBUS
Practice Address - State:OH
Practice Address - Zip Code:43228-9126
Practice Address - Country:US
Practice Address - Phone:614-876-6747
Practice Address - Fax:614-876-6311
Is Sole Proprietor?:Yes
Enumeration Date:2023-04-06
Last Update Date:2023-04-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHOP.017573-S156FX1800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes156FX1800XEye and Vision Services ProvidersTechnician/TechnologistOptician