Organization
RUNESTONE EYE CARE, INC.
Active
Other names
Runestone Eye Care
Organization subpart
No
Provider details
NPI number
Authorized official
DR. PAUL WILLIAM WYSOSKI O.D. (PRESIDENT)
(320) 759-1130
Entity
Organization
Contact information
Practice address
3015 HIGHWAY 29 S, SUITE 4155, ALEXANDRIA, MN 56308-3486
(320) 759-1130
Mailing address
3015 HIGHWAY 29 S, SUITE 4155, ALEXANDRIA, MN 56308-3486
(320) 759-1130
Taxonomy
Speciality
Code
Description
License number
State
152W00000X
Optometrist
Primary
2383
MN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1024868
PREFERRED ONE
MN
01
—
2200241
MEDICA
MN
01
—
30701135
PRIMEWEST
MN
01
—
66Q23RU
BCBS
MN
01
—
66Q26RU
BCBS
MN
05
—
971325500
—
MN
Enumeration date
11/17/2005
Last updated
03/22/2011
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