Organization
DJ-MN INC
Active
Other names
Select Eyecare
Organization subpart
No
Provider details
NPI number
Authorized official
JANE THELEN (OWNER)
(763) 427-4000
Entity
Organization
Contact information
Practice address
12 BRIDGE SQ STE 101, ANOKA, MN 55303-2463
(763) 427-4000
Mailing address
12 BRIDGE SQ STE 101, ANOKA, MN 55303-2463
(763) 427-4000
Taxonomy
Speciality
Code
Description
License number
State
156FX1800X
Optician
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
005158000
—
MN
Enumeration date
01/17/2007
Last updated
12/09/2019
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