Organization
RED WING OPTOMETRIC CLINIC, P.A.
Active
Other names
eye care associates
Organization subpart
No
Provider details
NPI number
Authorized official
CHRIS J PALMER OD (VICE PRESIDENT)
(651) 388-9187
Entity
Organization
Contact information
Practice address
164 TYLER RD S, RED WING, MN 55066-1733
(651) 388-9187
Mailing address
164 TYLER RD S, RED WING, MN 55066-1733
(651) 388-9187
Taxonomy
Speciality
Code
Description
License number
State
152W00000X
Optometrist
Primary
2513
MN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0149240001
DMEPOS
MN
01
—
1007983
PREFERRED ONE
MN
01
—
11707
UCARE
MN
01
—
2200260
MEDICA
MN
01
—
4C831PA
BLUE CROSS BLUE SHIELD
MN
01
—
5C066RE
BLUE PLUS EYEWEAR
MN
01
—
64216RE
BLUE PLUS EXAMS
MN
Enumeration date
06/28/2005
Last updated
08/22/2020
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