Organization
SANTALUZ LIMITED, LLC
Active
Other names
Brevier Optical
Organization subpart
No
Provider details
NPI number
Authorized official
MR. JASON ERIC TRUCANO (OWNER)
(952) 401-1701
Entity
Organization
Contact information
Practice address
143 OAK ST, EXCELSIOR, MN 55331-3030
(952) 401-1701
(952) 401-7908
Mailing address
143 OAK ST, EXCELSIOR, MN 55331-3030
(952) 401-1701
(952) 401-7908
Taxonomy
Speciality
Code
Description
License number
State
152W00000X
Optometrist
Primary
—
—
152WC0802X
Corneal and Contact Management Optometrist
—
—
156FX1800X
Optician
—
—
207W00000X
Ophthalmology Physician
—
—
Other
Enumeration date
02/08/2010
Last updated
11/11/2010
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