Organization
L.C. OPTOMETRIC P.C.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. ANTHONY LOVCIK O.D. (OWNER)
(763) 416-1983
Entity
Organization
Contact information
Practice address
12131 ELM CREEK BLVD N, MAPLE GROVE, MN 55369-7093
(763) 416-1983
(763) 416-4084
Mailing address
12131 ELM CREEK BLVD N, MAPLE GROVE, MN 55369-7093
(763) 416-1983
(763) 416-4084
Taxonomy
Speciality
Code
Description
License number
State
152W00000X
Optometrist
Primary
2638
MN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1204389
AETNA
MN
01
—
60P13LO
BLUE CROSS GROUP NUMBER
MN
01
—
96531
HEALTH PARTNERS GROUP NUM
MN
Enumeration date
06/14/2007
Last updated
08/22/2020
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