Organization
LANTZ OPTICAL CO
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MRS. CASSANDRA K AMUNDSON (OWNER)
(320) 251-2820
Entity
Organization
Contact information
Practice address
900 WEST ST GERMAIN, ST CLOUD, MN 56301
(320) 251-2820
Mailing address
900 WEST ST GERMAIN, ST CLOUD, MN 56301
(320) 251-2820
Taxonomy
Speciality
Code
Description
License number
State
332H00000X
Eyewear Supplier
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
291NOLA
BLUE CROSS BLUE SHIELD OF MINNESOTA
MN
Enumeration date
01/02/2007
Last updated
06/26/2008
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