Individual
DR. LANCE EMIL GUTFLEISCH
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
O.D.
Contact information
Practice address
2000 NE COURT, BLOOMINGTON, MN 55425-5506
(952) 853-1143
(952) 853-0591
Mailing address
PO BOX 464, WASECA, MN 56093-0464
(952) 465-2719
Taxonomy
Speciality
Code
Description
License number
State
152W00000X
Optometrist
Primary
2965
MN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
22-02832
MEDICA
MN
01
—
222525
EYEMED
MN
01
—
84M32GU
BCBS
MN
01
—
A02161044528
PREFERRED ONE
MN
Enumeration date
12/05/2006
Last updated
07/08/2007
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