Iris Vision Care, Llc. | |
1301 33rd St S Suite 104 Saint Cloud MN 56301-9668 | |
(320) 281-4787 | |
Not Available |
Full Name | Iris Vision Care, Llc. |
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Speciality | Clinic/Center |
Location | 1301 33rd St S, Saint Cloud, Minnesota |
Authorized Official Name and Position | Sally Beth Jackula (OWNER) |
Authorized Official Contact | 3202814787 |
Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
Mailing Address | Practice Location Address |
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Iris Vision Care, Llc. 1301 33rd St S Suite 104 Saint Cloud MN 56301-9668 Ph: (320) 281-4787 | Iris Vision Care, Llc. 1301 33rd St S Suite 104 Saint Cloud MN 56301-9668 Ph: (320) 281-4787 |
NPI Number | 1679708887 |
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Provider Enumeration Date | 05/18/2009 |
Last Update Date | 05/18/2009 |
Medicare PECOS PAC ID | 2860538337 |
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Medicare Enrollment ID | O20091014000282 |
Identifier | Type | State | Issuer |
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1679708887 | NPI | - | NPPES |
Taxonomy | Type | License (State) | Status |
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261Q00000X | Clinic/center | 2757 (Minnesota) | Primary |
Provider Name | Sally B Jackula |
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Provider Type | Practitioner - Optometry |
Provider Identifiers | NPI Number: 1902804149 PECOS PAC ID: 3476569112 Enrollment ID: I20060303000518 |
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