| NPI | 1376680165 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | BETH SEATON ULRICH Authorized Offical/COO 651-636-3434 |
| Organization Subpart ? | No |
| Primary Taxonomy | 152W00000X Optometrist |
| Additional Taxonomies | 332H00000X Eyewear Supplier (Equipment, not the service) |
| Enumeration Date | 2007-01-31 |
| Last Update Date | 2025-03-21 |