Individual
MARY M ZEISE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
O.D.
Contact information
Practice address
1 3RD AVE NE, CROSBY, MN 56441-1665
(218) 546-5108
(218) 546-5736
Mailing address
1 3RD AVE NE, CROSBY, MN 56441-1665
(218) 546-5108
(218) 546-5736
Taxonomy
Speciality
Code
Description
License number
State
152W00000X
Optometrist
Primary
2457
MN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
2202817
MEDICA
MN
01
—
326K9ZE
BLUE CROSS & BLUE SHIELD
MN
05
—
918814200
—
MN
01
—
P00234566
TRAVELERS MEDICARE
MN
Enumeration date
05/26/2006
Last updated
07/12/2013
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