Provider Demographics
NPI:1154440360
Name:MYHRE, ROBERT J (LDO)
Entity Type:Individual
Prefix:MR
First Name:ROBERT
Middle Name:J
Last Name:MYHRE
Suffix:
Gender:M
Credentials:LDO
Other - Prefix:
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Other - Credentials:
Mailing Address - Street 1:80 BAYLOR DR
Mailing Address - Street 2:STE 104
Mailing Address - City:BLUFFTON
Mailing Address - State:SC
Mailing Address - Zip Code:29910-8900
Mailing Address - Country:US
Mailing Address - Phone:843-706-3022
Mailing Address - Fax:843-706-3027
Practice Address - Street 1:80 BAYLOR DR
Practice Address - Street 2:STE 104
Practice Address - City:BLUFFTON
Practice Address - State:SC
Practice Address - Zip Code:29910-8900
Practice Address - Country:US
Practice Address - Phone:843-706-3022
Practice Address - Fax:843-706-3027
Is Sole Proprietor?:No
Enumeration Date:2007-03-28
Last Update Date:2020-05-01
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
SC741156FX1800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes156FX1800XEye and Vision Services ProvidersTechnician/TechnologistOptician