Organization
DR. BRUCE LEBERT OD
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. BRUCE ELDEN LEBERT O.D. (OPTOMETRIST)
(651) 351-5049
Entity
Organization
Contact information
Practice address
6575 CAHILL AVE STE 101, INVER GROVE HEIGHTS, MN 55076-2065
(651) 451-1100
(651) 451-3939
Mailing address
1605 JOHNSON DR, STILLWATER, MN 55082-4138
(651) 351-5049
Taxonomy
Speciality
Code
Description
License number
State
152W00000X
Optometrist
Primary
1591000
MN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
693823000
—
MN
Enumeration date
03/18/2008
Last updated
08/22/2012
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