Organization
ACKERMANN TOTAL EYE CARE INC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MICHAEL DAVID ACKERMANN OD (OPTOMETRIST OWNER)
(651) 345-3039
Entity
Organization
Contact information
Practice address
117 W CENTER ST, LAKE CITY, MN 55041-1635
(651) 345-3039
(651) 345-3506
Mailing address
117 W CENTER ST, LAKE CITY, MN 55041-1635
(651) 345-3039
(651) 345-3506
Taxonomy
Speciality
Code
Description
License number
State
152W00000X
Optometrist
Primary
2672
MN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
263917000
—
MN
01
—
80G68AC
BLUE CROSS BLUE SHIELD
MN
Enumeration date
03/02/2007
Last updated
04/23/2008
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