NPI 1902792849 · live from the CMS NPI Registry
Jacob Dilworth
Optometrist in Polson, MT. National Provider Identifier 1902792849, active.
NPI record
| NPI | 1902792849 Type 1 · individual |
|---|---|
| Status | Active |
| Primary specialty | Optometrist 152W00000X |
| Practice location | 203a Ridgewater Dr, Polson, MT 59860 |
| Practice phone | 406-883-4355 |
| Enumerated | June 17, 2025 |
| Last updated | June 17, 2025 |
| Sole proprietor | No |
Taxonomies and licenses
| Taxonomy | Code | License |
|---|---|---|
| Optometrist primary | 152W00000X | 5587 (MT) |
Source: CMS NPPES NPI Registry. NPI data is self-reported by providers; license numbers are not verified by CMS.