Organization
PERSONALITY EYEWEAR
Active
Organization subpart
No
Provider details
NPI number
Authorized official
ROOSEVELT LEE WILLIAMS III (OWNER)
(612) 940-7111
Entity
Organization
Contact information
Practice address
8257 LOGAN AVE N, BROOKLYN PARK, MN 55444-1545
(612) 940-7111
Mailing address
8257 LOGAN AVE N, BROOKLYN PARK, MN 55444-1545
(612) 940-7111
Taxonomy
Speciality
Code
Description
License number
State
156FX1800X
Optician
Primary
—
—
Other
Enumeration date
12/22/2016
Last updated
12/22/2016
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