Individual
DR. MATTHEW LEPAGE
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
OD
Contact information
Practice address
401 PHALEN BLVD FL 2, SAINT PAUL, MN 55130-5302
(952) 967-7611
Mailing address
8170 33RD AVE S # MS 21110Q, MINNEAPOLIS, MN 55425-4516
Taxonomy
Speciality
Code
Description
License number
State
152W00000X
Optometrist
Primary
3829
MN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
3829
MN BOARD OF OPTOMETRY LICENSE NUMBER
MN
Enumeration date
12/20/2022
Last updated
02/06/2023
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