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Organization

LAKE REGION EYE CENTER

Active
Organization subpart
No

Provider details

NPI number
Authorized official
DAVID SCHNEIDERHAN (OWNER/OPTICIAN)
(320) 763-7055
Entity
Organization

Contact information

Practice address
610 30TH AVE W, STE 200, ALEXANDRIA, MN 56308-3426
(320) 763-7055
(320) 763-2572
Mailing address
610 30TH AVE W STE 200, ALEXANDRIA, MN 56308-3426
(320) 763-7055
(320) 763-2572

Taxonomy

Speciality
Code
Description
License number
State
152W00000X
Optometrist
Primary
MN2707
MN

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
127518600
MN
05
355300134
MN
05
428670300
MN
05
597816500
MN
05
914218500
MN
Enumeration date
07/12/2005
Last updated
04/04/2017
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