Provider Demographics
NPI:1881186302
Name:TRAN, JENNY (OD)
Entity Type:Individual
Prefix:
First Name:JENNY
Middle Name:
Last Name:TRAN
Suffix:
Gender:F
Credentials:OD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3330 KENT RD
Mailing Address - Street 2:
Mailing Address - City:STOW
Mailing Address - State:OH
Mailing Address - Zip Code:44224-4537
Mailing Address - Country:US
Mailing Address - Phone:330-688-8811
Mailing Address - Fax:
Practice Address - Street 1:3330 KENT RD
Practice Address - Street 2:
Practice Address - City:STOW
Practice Address - State:OH
Practice Address - Zip Code:44224-4537
Practice Address - Country:US
Practice Address - Phone:330-688-8811
Practice Address - Fax:330-688-9550
Is Sole Proprietor?:No
Enumeration Date:2018-05-31
Last Update Date:2021-01-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHOPT.006667152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152W00000XEye and Vision Services ProvidersOptometrist