Sortor, Jennifer Mazzola

Sortor, Jennifer Mazzola is an individual health care provider with primary practice located at 2433 Oak Valley Dr Suite 300, Ann Arbor MI 48103-7602. She recently has 5 registered licenses in different health care specialties including Eye and Vision Services Providers / Optometrist, Eye and Vision Services Providers / Pediatrics, Eye and Vision Services Providers / Sports Vision, Eye and Vision Services Providers / Vision Therapy, Eye and Vision Services Providers / Occupational Vision. Eye and Vision Services Providers / Optometrist is her primary health care specialty. Sortor, Jennifer Mazzola can be contacted via phone (734) 994-0100.

Contact Information

Primary practice address
2433 Oak Valley Dr Suite 300 Ann Arbor MI 48103-7602
Fax: (734) 994-9625
Website:

Health care specialties

SpecialtyCodeLicense #State
Eye and Vision Services Providers / Optometrist 152W00000X 4901004033 Michigan
Eye and Vision Services Providers / Pediatrics 152WP0200X 4901004033 Michigan
Eye and Vision Services Providers / Sports Vision 152WS0006X 4901004033 Michigan
Eye and Vision Services Providers / Vision Therapy 152WV0400X 4901004033 Michigan
Eye and Vision Services Providers / Occupational Vision 152WX0102X 4901004033 Michigan

Profile Details

NPI number 1578555884
LBN Legal business name Sortor, Jennifer Mazzola
Credentials Doctor of Optometry (OD)
Entity Individual
Sole proprietor 1 No
Enumeration date Aug 22nd, 2005
Last updated Nov 20th, 2007 - about 17 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1578555884 NPPES
Michigan MEDICAID 4175195
Michigan Other JS004033

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