Organization
KENNEDY VISION HEALTH CENTER, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. ANTHONY CHARLES TRAVERSE OD (OD/OWNER)
(763) 545-8850
Entity
Organization
Contact information
Practice address
9075 QUANTRELLE AVE NE STE 300, OTSEGO, MN 55330-0139
(763) 545-8850
(763) 441-7631
Mailing address
10600 OLD COUNTY ROAD 15, PLYMOUTH, MN 55441-6200
(763) 373-6042
(763) 441-7631
Taxonomy
Speciality
Code
Description
License number
State
152W00000X
Optometrist
Primary
—
—
Other
Enumeration date
08/27/2024
Last updated
08/27/2024
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