Provider Demographics
NPI:1750616140
Name:LABREE, JEREMIAH (OPTOMETRIST)
Entity type:Individual
Prefix:DR
First Name:JEREMIAH
Middle Name:
Last Name:LABREE
Suffix:
Gender:M
Credentials:OPTOMETRIST
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 568
Mailing Address - Street 2:
Mailing Address - City:ROCKLAND
Mailing Address - State:ME
Mailing Address - Zip Code:04841-0484
Mailing Address - Country:US
Mailing Address - Phone:207-594-9555
Mailing Address - Fax:
Practice Address - Street 1:20 OAK STREET
Practice Address - Street 2:
Practice Address - City:ROCKLAND
Practice Address - State:ME
Practice Address - Zip Code:04841-0484
Practice Address - Country:US
Practice Address - Phone:207-594-9555
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2009-10-02
Last Update Date:2009-10-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MEOPT908152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152W00000XEye and Vision Services ProvidersOptometrist