Individual
PATRICK J MARTIN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
PEARLE VISION, 1056 BURNSVILLE CENTER, BURNSVILLE, MN 55306
(952) 435-8821
(952) 435-1624
Mailing address
41 S SUTTON LAKE BLVD, JORDAN, MN 55352-9467
(952) 492-3915
(952) 435-1624
Taxonomy
Speciality
Code
Description
License number
State
152W00000X
Optometrist
Primary
2093
MN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
3C309MA
BLUE CROSS BLUE SHIELD
MN
05
—
549023500
—
MN
01
—
911361
EYE MED / COLE VISION
MN
Enumeration date
10/04/2006
Last updated
09/02/2024
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