| NPI | 1508839879 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | THOMAS SAMUELSON Owner 952-888-5800 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207W00000X Ophthalmology |
| Additional Taxonomies | 152WC0802X Optometrist, Corneal and Contact Management |
| 207WX0120X Ophthalmology, Cornea and External Diseases Specialist | |
| 291U00000X Clinical Medical Laboratory (Licence: MN 24D2023179) | |
| 332H00000X Eyewear Supplier (Equipment, not the service) | |
| Enumeration Date | 2006-02-08 |
| Last Update Date | 2024-10-01 |