Organization
VISTA FAMILY EYE CARE LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. VIVIAN O EKEMEZIE OD (OPTOMETRIST)
(763) 843-7153
Entity
Organization
Contact information
Practice address
9920 FOLEY BLVD NW STE 120, COON RAPIDS, MN 55433
(763) 843-7153
Mailing address
9920 FOLEY BLVD NW, COON RAPIDS, MN 55433-4579
Taxonomy
Speciality
Code
Description
License number
State
152W00000X
Optometrist
Primary
3311
MN
Other
Enumeration date
11/09/2017
Last updated
05/31/2018
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