| NPI | 1538624341 |
|---|---|
| Doing Business As | FOUR SEASONS EYECARE - MAPLE GROVE |
| Entity Type | Organization |
| Authorized Contact | JENNIE J SEALOCK Secr/Treas 763-559-7358 |
| Organization Subpart ? | Yes |
| Primary Taxonomy | 332H00000X Eyewear Supplier (Equipment, not the service) |
| Enumeration Date | 2019-02-06 |
| Last Update Date | 2019-02-06 |