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General NPI Number Information
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NPI Number | 1487695995
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Entity Type | Organization
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Legal Business Name | JAN'S OPTICAL, INC.
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Dates
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Enumeration Date | 06/08/2006
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Last Update Date | 11/26/2007
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Provider Practice Location Address
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Address Line | 409 N CHESTNUT AVE
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City | MARSHFIELD
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State | WI
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Zip | 54449-2013
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Country | US
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Telephone | 715-387-1844
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Fax | 715-387-4213
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Provider Business Mailing Address
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Address Line | 409 N CHESTNUT AVE POST OFFICE BOX 1296
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City | MARSHFIELD
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State | WI
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Zip | 54449-2013
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Country | US
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Telephone | 715-387-1844
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Fax | 715-387-4213
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Authorized Official
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Title or Position | PRESIDENT
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Name | MS. JANICE M RASMUSSEN
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Credential |
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Telephone | 715-387-1844
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 152W00000X
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Taxonomy Name | Optometrist
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License Number |
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License Number State |
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