Distinctive Eyewear Llc

NPI 1043392632 - Technician/Technologist - 156FX1800X

NPI Details
NPI 1043392632
Enumeration Date 10/20/2006
Last Updated 05/29/2013
Entity Type Healthcare Provider
Active Over 10 years ago
Authorized Information
Name AUDREY IRENE AUDREY
Position BUSINESS OFFICE SUPERVISOR
Phone (763) 416-7600
Fax
Practice Location
12000 ELM CREEK BLVD N
SUITE 100
MAPLE GROVE MN, 55369-7073, US
Phone (763) 416-7600
Fax
Business Location
12000 ELM CREEK BLVD N
SUITE 100
MAPLE GROVE MN, 55369-7073, US
Phone (763) 416-7600
Fax (763) 416-7621
Toxanomy
Taxonomy Code 156FX1800X
License State
License Number
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According to our database, Distinctive Eyewear Llc NPI is 1043392632, taxonomy code is 156FX1800X Distinctive Eyewear Llc physically located at 12000 Elm Creek Blvd N, Maple Grove MN, 55369-7073. NPI Number 1033115704 has the healthcare provider type.

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1043392632 NPI number is provided on an as is basis without warranty of any kind. 1043392632 is maintained by the National Plan & Provider Enumeration System. The contents of Distinctive Eyewear Llc are for informational purposes only.