Organization
PINECONE VISION CENTER
Active
Organization subpart
No
Provider details
NPI number
Authorized official
CHRISSY HENRY (BUSINESS OFFICE MANAGER)
(320) 258-3915
Entity
Organization
Contact information
Practice address
2180 TROOP DRIVE, SARTELL, MN 56377-4563
(320) 258-3915
(320) 258-3917
Mailing address
2180 TROOP DRIVE, SARTELL, MN 56377-4563
(320) 258-3915
(320) 258-3917
Taxonomy
Speciality
Code
Description
License number
State
152W00000X
Optometrist
Primary
—
—
152WC0802X
Corneal and Contact Management Optometrist
—
—
152WL0500X
Low Vision Rehabilitation Optometrist
—
—
152WP0200X
Pediatric Optometrist
—
—
Other
Enumeration date
07/17/2015
Last updated
07/17/2015
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