Organization
MONTICELLO OPTICAL CENTER INC.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. JOHN MARK CAVANAGH O.D. (PRESIDENT)
(651) 636-2020
Entity
Organization
Contact information
Practice address
261 E BROADWAY ST, MONTICELLO, MN 55362-9317
(763) 295-5292
Mailing address
2655 INNSBRUCK DR STE B, NEW BRIGHTON, MN 55112-9304
(651) 636-2020
Taxonomy
Speciality
Code
Description
License number
State
152W00000X
Optometrist
Primary
—
—
Other
Enumeration date
07/24/2017
Last updated
07/24/2017
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