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Organization

WADENA EYE CLINIC LTD

Active
Organization subpart
No

Provider details

NPI number
Authorized official
MRS. CYNTHIA A MILLER (BUSINESS MANAGER)
(218) 631-2020
Entity
Organization

Contact information

Practice address
222 SOUTHEAST FIRST STREET, WADENA, MN 56482-1567
(218) 631-2020
(218) 631-1892
Mailing address
222 SOUTHEAST FIRST STREET, WADENA, MN 56482-1567
(218) 631-2020
(218) 631-1892

Taxonomy

Speciality
Code
Description
License number
State
152W00000X
Optometrist
Primary
MN

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
2116301
MEDICA
MN
05
297717600
MN
01
57331
HEALTHPARTNERS
MN
01
5C053WA
BLUE PLUS
MN
01
83294MI
BLUE CROSS BLUE SHIELD
MN
01
999995764
VSP-DR.MILLER
MN
01
999995765
VSP-DR.TABBERT
MN
Enumeration date
10/02/2006
Last updated
07/21/2022
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