Organization
THE LOW VISION STORE
Active
Organization subpart
No
Provider details
NPI number
Authorized official
TERRY NELSON (PRESIDENT)
(651) 203-2200
Entity
Organization
Contact information
Practice address
2200 UNIVERSITY AVE W, SUITE 200, SAINT PAUL, MN 55114-1839
(651) 203-2200
(651) 203-2203
Mailing address
2200 UNIVERSITY AVE W, SUITE 200, SAINT PAUL, MN 55114-1839
(651) 203-2200
(651) 203-2203
Taxonomy
Speciality
Code
Description
License number
State
332BC3200X
Customized Equipment (DME)
Primary
—
—
Other
Enumeration date
11/28/2012
Last updated
11/28/2012
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