Organization
ICARE OPTICAL, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. CHONBURI LEE (OWNER)
(651) 373-0914
Entity
Organization
Contact information
Practice address
1001 JOHNSON PKWY, STE 271, SAINT PAUL, MN 55106-3474
(651) 315-1766
(651) 318-3651
Mailing address
1815 ROSS AVE E, SAINT PAUL, MN 55119-3431
(651) 315-1766
(651) 318-3651
Taxonomy
Speciality
Code
Description
License number
State
332BC3200X
Customized Equipment (DME)
Primary
—
—
Other
Enumeration date
11/13/2013
Last updated
11/13/2013
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