Provider Demographics
NPI:1396976221
Name:JAMMER, ANGELA L (OD)
Entity type:Individual
Prefix:
First Name:ANGELA
Middle Name:L
Last Name:JAMMER
Suffix:
Gender:F
Credentials:OD
Other - Prefix:
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Mailing Address - Street 1:1950 OLD GALLOWS RD STE 520
Mailing Address - Street 2:
Mailing Address - City:VIENNA
Mailing Address - State:VA
Mailing Address - Zip Code:22182-3970
Mailing Address - Country:US
Mailing Address - Phone:703-847-8899
Mailing Address - Fax:571-223-6780
Practice Address - Street 1:590 E 16TH ST STE 20
Practice Address - Street 2:
Practice Address - City:HOLLAND
Practice Address - State:MI
Practice Address - Zip Code:49423-3702
Practice Address - Country:US
Practice Address - Phone:616-928-9640
Practice Address - Fax:616-928-9641
Is Sole Proprietor?:No
Enumeration Date:2009-07-27
Last Update Date:2021-04-05
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
MI4901004521152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152W00000XEye and Vision Services ProvidersOptometrist