| |
3745 Louisiana Ave S, St. Louis Park, MN 55426 | |
(952) 922-4427 | |
(952) 922-4761 |
Full Name | |
---|---|
Type | Facility |
Speciality | Optometrist |
Location | 3745 Louisiana Ave S, St. Louis Park, Minnesota |
Accepts Medicare Assignments | Does not participate in Medicare Program. The facility may not accept medicare assignment. |
Identifier | Type | State | Issuer |
---|---|---|---|
1497828842 | NPI | - | NPPES |
2201839 | Other | MN | MEDICA |
300J5BE | Other | MN | BCBS |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
152W00000X | Optometrist | 2621 (Minnesota) | Primary |
Mailing Address | Practice Location Address |
---|---|
290 Greenleaf Ct., Chanhassen, MN 55317 Ph: (952) 403-1694 | 3745 Louisiana Ave S, St. Louis Park, MN 55426 Ph: (952) 922-4427 |
Dr. Heather Marie Bergerud, OD Optometrist Medicare: Medicare Enrolled Practice Location: 3745 Louisiana Ave S, St. Louis Park, MN 55426 Phone: 952-922-4427 Fax: 952-922-4761 |