Organization
MEDICAL EYE CENTER OPTICAL INC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
KEITH CASEBOLT (CEO)
(541) 779-4711
Entity
Organization
Contact information
Practice address
881 NE 7TH ST, GRANTS PASS, OR 97526-1634
(541) 476-6302
(541) 476-1440
Mailing address
2727 E BARNETT RD, MEDFORD, OR 97504-8331
(541) 779-4711
(541) 618-1485
Taxonomy
Speciality
Code
Description
License number
State
332H00000X
Eyewear Supplier
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
040654
—
OR
Enumeration date
04/17/2008
Last updated
02/20/2009
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