Individual
JACQUELINE M MCCALL
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
OD
Contact information
Practice address
7870 EXCELSIOR RD, BAXTER, MN 56425-8427
(218) 828-9545
(218) 828-1572
Mailing address
7870 EXCELSIOR RD, BAXTER, MN 56425-8427
(218) 828-9545
(218) 828-1572
Taxonomy
Speciality
Code
Description
License number
State
152W00000X
Optometrist
Primary
2091
MN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
198523000
—
MN
01
—
46B89MC
BCBS OF MN
MN
Enumeration date
08/31/2005
Last updated
12/01/2014
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