| |
3540 Galleria, Edina, MN 55435-4218 | |
(952) 922-1052 | |
(952) 922-2518 |
Full Name | |
---|---|
Type | Facility |
Speciality | Eyewear Supplier |
Location | 3540 Galleria, Edina, Minnesota |
Accepts Medicare Assignments | Does not participate in Medicare Program. The facility may not accept medicare assignment. |
Identifier | Type | State | Issuer |
---|---|---|---|
1821243239 | NPI | - | NPPES |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
152W00000X | Optometrist | 1456 (Minnesota) | Secondary |
332H00000X | Eyewear Supplier | 1456 (Minnesota) | Primary |
Mailing Address | Practice Location Address |
---|---|
3540 Galleria, Edina, MN 55435-4218 Ph: (952) 922-1052 | 3540 Galleria, Edina, MN 55435-4218 Ph: (952) 922-1052 |