Organization
APOLADE INC
Active
Other names
Costco Optical
Organization subpart
No
Provider details
NPI number
Authorized official
MR. TIM J NELSON O.D. (PRESIDENT)
(612) 743-1400
Entity
Organization
Contact information
Practice address
11330 FOUNTAINS DR, MAPLE GROVE, MN 55369-7200
(763) 494-8063
(763) 494-8062
Mailing address
720 N 4TH ST UNIT 704, MINNEAPOLIS, MN 55401-1950
(612) 743-1400
Taxonomy
Speciality
Code
Description
License number
State
152W00000X
Optometrist
Primary
2827
MN
Other
Enumeration date
03/14/2007
Last updated
12/11/2018
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