Organization
MSP FAMILY EYE CLINIC, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. JOSEPH MAX KOSTECKI O.D. (PRESIDENT)
(952) 401-9202
Entity
Organization
Contact information
Practice address
4848 COUNTY ROAD 101, MINNETONKA, MN 55345-2635
(952) 401-9202
Mailing address
4848 COUNTY ROAD 101, MINNETONKA, MN 55345-2635
(952) 401-9202
Taxonomy
Speciality
Code
Description
License number
State
152W00000X
Optometrist
Primary
2820
MN
Other
Enumeration date
09/09/2014
Last updated
09/09/2014
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