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Organization

NORTH LAND OPTICAL CO

Active
Organization subpart
No

Provider details

NPI number
Authorized official
MR. RONALD CHARLES HORN JR. (OWNER)
(218) 722-4212
Entity
Organization

Contact information

Practice address
600 E SUPERIOR ST, STE 111, DULUTH, MN 55802-2222
(218) 722-4212
(218) 722-4212
Mailing address
600 E SUPERIOR ST, STE 111, DULUTH, MN 55802-2222
(218) 722-4212
(218) 722-4212

Taxonomy

Speciality
Code
Description
License number
State
156FX1800X
Optician
Primary

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
110498
UCARE MN GLASSES
MN
01
111276
UCARE MN VISION
MN
01
2100559
MEDICA GLASSES
MN
01
2200240
MEDICA VISION
MN
01
61773
HEALTH PARTNERS GLASSES
01
74610NO
BCBS
MN
01
74610NO
FIRST PLAN BLUE
05
794562100
MN
01
HP29194
HEALTH PARTNERS VISION
Enumeration date
10/19/2005
Last updated
06/29/2011
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