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Organization

CORNEA AND CONTACT LENS INSTITUTE OF MINNESOTA

Active
Organization subpart
No

Provider details

NPI number
Authorized official
JASON JEDLICKA OD (OWNER)
(952) 641-6226
Entity
Organization

Contact information

Practice address
5137 GUS YOUNG LN, EDINA, MN 55436-1530
(952) 641-6226
Mailing address
PO BOX 1170, MAPLE GROVE, MN 55311-6170
(763) 746-2094

Taxonomy

Speciality
Code
Description
License number
State
152W00000X
Optometrist
Primary
LD2631
207W00000X
Ophthalmology Physician
44481
MN

Other

Enumeration date
11/04/2010
Last updated
03/21/2011
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