Organization
ROCHESTER FAMILY EYE CLINIC LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. TERRANCE DUANE DOWNS (PRACTICE MGR)
(507) 288-2467
Entity
Organization
Contact information
Practice address
3630 11TH AVE NW, ROCHESTER, MN 55901-4276
(507) 288-2457
(507) 288-1299
Mailing address
3630 11TH AVE NW, ROCHESTER, MN 55901-4276
(507) 288-2457
(507) 288-1299
Taxonomy
Speciality
Code
Description
License number
State
152W00000X
Optometrist
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
01017731
PREFERRED ONE
—
01
—
4C932EA
BLUE CROSS SHIELD
MN
01
—
52134JO
BLUE CROSS BLUE SHEILD MN
MN
Enumeration date
11/30/2005
Last updated
04/07/2008
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