Individual
JOYCE MARIE SCHANZENBACH
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
O.D.
Contact information
Practice address
8101 OLD CARRIAGE CT, SHAKOPEE, MN 55379-3155
(952) 445-8092
Mailing address
5540 OVERLOOK CIR SE, PRIOR LAKE, MN 55372-3375
(952) 447-2166
Taxonomy
Speciality
Code
Description
License number
State
152W00000X
Optometrist
Primary
2603
MN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
16876
SPECTERA
MN
01
—
201L8SC
BCBS
MN
01
—
22-01929
MEDICA
MN
01
—
244331019179
PREFERREDONE
MN
05
—
819003800
—
MN
Enumeration date
08/16/2006
Last updated
07/09/2007
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