Organization
JD EYES, INC
Active
Other names
Pearle Vision
Organization subpart
No
Provider details
NPI number
Authorized official
DR. KARA DURICK JOHNSON O.D. (VICE PRESIDENT)
(763) 355-8512
Entity
Organization
Contact information
Practice address
12771 RIVERDALE BLVD NW, SUITE 103, COON RAPIDS, MN 55448-1262
(763) 421-1220
Mailing address
12771 RIVERDALE BLVD NW, SUITE 103, COON RAPIDS, MN 55448-1262
(763) 421-1220
Taxonomy
Speciality
Code
Description
License number
State
152W00000X
Optometrist
Primary
MN2732
MN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
005323600
—
MN
Enumeration date
03/10/2014
Last updated
03/10/2014
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