| |
506 7th St W, Saint Paul, MN 55102-3006 | |
(651) 333-4420 | |
(651) 204-0966 |
Full Name | |
---|---|
Type | Facility |
Speciality | Technician/technologist |
Location | 506 7th St W, Saint Paul, Minnesota |
Accepts Medicare Assignments | Does not participate in Medicare Program. The facility may not accept medicare assignment. |
Identifier | Type | State | Issuer |
---|---|---|---|
1861827578 | NPI | - | NPPES |
1285900548 | Other | MN | NPI 1 |
12191422 | Other | MN | CAQH |
1396125837 | Other | NPI 1 | |
1831361302 | Other | MN | NPI 1 |
1073591939 | Other | MN | NPI 1 |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
152W00000X | Optometrist | (Minnesota) | Secondary |
156F00000X | Technician/technologist | (* (Not Available)) | Primary |
Mailing Address | Practice Location Address |
---|---|
506 7th St W, Saint Paul, MN 55102-3006 Ph: (651) 333-4420 | 506 7th St W, Saint Paul, MN 55102-3006 Ph: (651) 333-4420 |