Organization
NICOLLET VISION CARE OPTOMETRISTS P.A.
Active
Other names
The Glasses Menagerie
Organization subpart
No
Provider details
NPI number
Authorized official
DR. LINDA MARIE CHOUS O.D. (OWNER)
(612) 822-7021
Entity
Organization
Contact information
Practice address
3142 HENNEPIN AVE S, MINNEAPOLIS, MN 55408-2619
(612) 822-7021
(612) 822-6123
Mailing address
3142 HENNEPIN AVE S, MINNEAPOLIS, MN 55408-2619
(612) 822-7021
(612) 822-6123
Taxonomy
Speciality
Code
Description
License number
State
152WP0200X
Pediatric Optometrist
Primary
2219
MN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
102328
U CARE
MN
01
—
22-19849
MEDICA
—
01
—
45845
MHP
—
01
—
4C348GL
BLUE PLUS
—
05
—
610225500
—
MN
01
—
64637CH
BLUE CROSS
—
Enumeration date
11/11/2008
Last updated
11/11/2008
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