Organization
LIFETIME EYE CARE OF ROCHESTER INC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. JEFFREY LEON ANDERSON O.D. (OPTOMETRIST)
(507) 282-7121
Entity
Organization
Contact information
Practice address
3632 10TH LN NW, SUITE 2, ROCHESTER, MN 55901-7032
(507) 282-7121
Mailing address
3632 10TH LN NW, SUITE 2, ROCHESTER, MN 55901-7032
(507) 282-7121
Taxonomy
Speciality
Code
Description
License number
State
152W00000X
Optometrist
Primary
2665
MN
332H00000X
Eyewear Supplier
2665
MN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
09Y96LI
BLUE CROSS BLUE SHIELD
MN
01
—
09Y97AN
BLUE CROSS BLUE SHIELD
MN
01
—
09Y98SI
BLUE CROSS BLUE SHIELD
MN
01
—
09Y99LI
BLUE CROSS BLUE SHIELD
MN
Enumeration date
06/10/2008
Last updated
04/01/2009
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