Organization
GORMAN OPTICAL INC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
JOAN MARIE GORMAN MEYER ABOC (OWNER CERTIFIED OPTICIAN)
(651) 639-8227
Entity
Organization
Contact information
Practice address
2797 HAMLINE AVE NO, HAMLINE CENTER SUITE 2, ROSEVILLE, MN 55113-1715
(651) 639-8227
(651) 633-7010
Mailing address
2797 HAMLINE AVE NO, HAMLINE CENTER SUITE 2, ROSEVILLE, MN 55113-1715
(651) 639-8227
(651) 633-7010
Taxonomy
Speciality
Code
Description
License number
State
156FX1800X
Optician
Primary
072582
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1B06D56G0
BLUE CROSS B S
MN
Enumeration date
12/27/2007
Last updated
12/27/2007
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