Provider Demographics
NPI:1821416082
Name:EYE CARE OF JOHN DAY
Entity Type:Organization
Organization Name:EYE CARE OF JOHN DAY
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:SECRETARY
Authorized Official - Prefix:
Authorized Official - First Name:ASHLEY
Authorized Official - Middle Name:B
Authorized Official - Last Name:LABHART
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:541-575-1819
Mailing Address - Street 1:401 W MAIN ST STE A
Mailing Address - Street 2:
Mailing Address - City:JOHN DAY
Mailing Address - State:OR
Mailing Address - Zip Code:97845-1075
Mailing Address - Country:US
Mailing Address - Phone:541-575-1819
Mailing Address - Fax:541-575-0965
Practice Address - Street 1:401 W MAIN ST STE A
Practice Address - Street 2:
Practice Address - City:JOHN DAY
Practice Address - State:OR
Practice Address - Zip Code:97845-1075
Practice Address - Country:US
Practice Address - Phone:541-575-1819
Practice Address - Fax:541-575-0965
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2014-04-03
Last Update Date:2014-04-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OR3534AT152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes152W00000XEye and Vision Services ProvidersOptometristGroup - Single Specialty