Organization
BELLE PLAINE EYECARE CENTER LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. ZACHARY DIRKS OD (MANAGING OPTOMETRIST)
(507) 931-6436
Entity
Organization
Contact information
Practice address
168 COMMERCE DR E, BELLE PLAINE, MN 56011-2901
(952) 873-5554
Mailing address
320 SUNRISE DR, SAINT PETER, MN 56082-1352
(507) 931-6436
Taxonomy
Speciality
Code
Description
License number
State
152W00000X
Optometrist
Primary
3080
MN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
139494
UCARE NUMBER
MN
05
—
498660000
—
MN
Enumeration date
10/03/2014
Last updated
01/21/2015
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