Organization
SOUTHWEST EYE CARE
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MS. KRISTI LEANN NARUM (BUSINESS MANAGER)
(952) 466-3937
Entity
Organization
Contact information
Practice address
304 W HIGHWAY 212, NORWOOD YOUNG AMERICA, MN 55368-9775
(952) 467-2250
(952) 467-2270
Mailing address
1464 WHITE OAK DR, CHASKA, MN 55318-2525
(952) 466-3937
(952) 466-3936
Taxonomy
Speciality
Code
Description
License number
State
152W00000X
Optometrist
Primary
2627
MN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1104975762
NPI CHAD DOCKTER
MN
01
—
1770631889
NPI CHRISTOPHER FREED
MN
01
—
1881741213
AMY FREED
MN
01
—
1922004514
NPI GREGORY MACIK
MN
05
—
617518000
—
MN
05
—
650127300
—
MN
05
—
683719100
—
MN
05
—
958906600
—
MN
Enumeration date
04/06/2007
Last updated
04/30/2008
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