Organization
BRAINERD EYECARE CENTER, PA
Active
Organization subpart
No
Provider details
NPI number
Authorized official
ANNE ARCHIBALD (CFO)
(218) 829-0946
Entity
Organization
Contact information
Practice address
506 LAUREL ST., BRAINERD, MN 56401-3526
(218) 829-0946
(218) 829-1279
Mailing address
506 LAUREL ST., BRAINERD, MN 56401-3526
(218) 829-0946
(218) 829-1279
Taxonomy
Speciality
Code
Description
License number
State
152W00000X
Optometrist
—
—
156FX1800X
Optician
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
4C345BR
BLUE CROSS
MN
Enumeration date
06/20/2012
Last updated
01/16/2023
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