Individual
JASON CHARLES LABRIE
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
D.O.
Contact information
Practice address
107 E OAK AVE, FLAGSTAFF, AZ 86001-1818
(928) 779-7880
(928) 779-7895
Mailing address
1200 N BEAVER ST, FLAGSTAFF, AZ 86001-3118
(928) 213-6235
(928) 213-6292
Taxonomy
Speciality
Code
Description
License number
State
207X00000X
Orthopaedic Surgery Physician
Primary
007850
AZ
207X00000X
Orthopaedic Surgery Physician
8473
SD
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1254560001
DME SUPPLIER NUMBER
SD
05
—
6402620
—
SD
Enumeration date
06/28/2007
Last updated
01/18/2021
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