Organization
JACKSONVILLE VISION CLINIC INC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
JULIE DANIELSON O.D. (OPTOMETRIST)
(541) 899-2020
Entity
Organization
Contact information
Practice address
950 N 5TH ST, JACKSONVILLE, OR 97530-9016
(541) 899-2020
(541) 899-1481
Mailing address
950 N 5TH ST, JACKSONVILLE, OR 97530-9016
(541) 899-2020
(541) 899-1481
Taxonomy
Speciality
Code
Description
License number
State
152W00000X
Optometrist
Primary
3036ATI
OR
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
210539
—
OR
Enumeration date
05/21/2009
Last updated
05/03/2012
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