| NPI | 1659556264 |
|---|---|
| Doing Business As | MAPLE GROVE EYE CLINIC |
| Entity Type | Organization |
| Authorized Contact | ALISSA LINDSTROM Insurance COO Rdinator 763-420-6981 |
| Organization Subpart ? | No |
| Primary Taxonomy | 332H00000X Eyewear Supplier |
| Additional Taxonomies | 152W00000X Optometrist (Licence: MN 1457) |
| Enumeration Date | 2008-01-02 |
| Last Update Date | 2011-03-04 |