Individual
JEAN L LAYMAN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
O.D.
Contact information
Practice address
4405 PHEASANT RIDGE DR NE, BLAINE, MN 55449-4531
(763) 784-9700
Mailing address
460 NORTHDALE BLVD NW, COON RAPIDS, MN 55448-3364
(763) 208-5832
Taxonomy
Speciality
Code
Description
License number
State
152W00000X
Optometrist
Primary
1943
MN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
2100738
MEDICA DISPENSING
MN
01
—
2203265
MEDICA
MN
01
—
477M7WA
BC/BS OF MN GRP #
MN
01
—
477M8LA
BC/BS OF MN IND #
MN
Enumeration date
08/31/2006
Last updated
11/21/2016
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