Organization
MINNESOTA EYECARE NETWORK, INC.
Active
Other names
Azure Vision Care
Organization subpart
No
Provider details
NPI number
Authorized official
MR. TIMOTHY C NEITZKE O.D. (PRESIDENT)
(218) 346-3310
Entity
Organization
Contact information
Practice address
652 JEFFERSON STREET N, WADENA, MN 56482-2307
(218) 631-1456
(218) 631-3213
Mailing address
652 JEFFERSON STREET N, WADENA, MN 56482-2307
(218) 631-1456
(218) 631-3213
Taxonomy
Speciality
Code
Description
License number
State
152W00000X
Optometrist
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
041388700
—
MN
Enumeration date
08/17/2006
Last updated
06/05/2015
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