Provider Demographics
NPI:1487695995
Name:JAN'S OPTICAL, INC.
Entity type:Organization
Organization Name:JAN'S OPTICAL, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:MS
Authorized Official - First Name:JANICE
Authorized Official - Middle Name:M
Authorized Official - Last Name:RASMUSSEN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:715-387-1844
Mailing Address - Street 1:409 N CHESTNUT AVE
Mailing Address - Street 2:POST OFFICE BOX 1296
Mailing Address - City:MARSHFIELD
Mailing Address - State:WI
Mailing Address - Zip Code:54449-2013
Mailing Address - Country:US
Mailing Address - Phone:715-387-1844
Mailing Address - Fax:715-387-4213
Practice Address - Street 1:409 N CHESTNUT AVE
Practice Address - Street 2:
Practice Address - City:MARSHFIELD
Practice Address - State:WI
Practice Address - Zip Code:54449-2013
Practice Address - Country:US
Practice Address - Phone:715-387-1844
Practice Address - Fax:715-387-4213
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-06-08
Last Update Date:2007-11-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes152W00000XEye and Vision Services ProvidersOptometristGroup - Single Specialty