| NPI | 1407955420 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JEFFREY BRUCE ANDERSON President 952-381-7611 |
| Organization Subpart ? | No |
| Primary Taxonomy | 152W00000X Optometrist |
| Additional Taxonomies | 261Q00000X Clinic/Center (Licence: MN 2956) |
| Enumeration Date | 2006-09-22 |
| Last Update Date | 2025-05-14 |