Organization
LE SUEUR EYECARE CENTER LLC
Active
Other names
Mootz Eye Clinic PA, Le Sueur Eyecare Center
Organization subpart
No
Provider details
NPI number
Authorized official
DR. ZACHARY BLAKE DIRKS OD (PARTNER)
(507) 469-9715
Entity
Organization
Contact information
Practice address
101 MAIN ST S STE 103, LE SUEUR, MN 56058-7503
(507) 665-3366
(507) 665-3990
Mailing address
101 MAIN ST S STE 103105, LE SUEUR, MN 56058-7502
(507) 665-3366
(507) 665-3990
Taxonomy
Speciality
Code
Description
License number
State
152W00000X
Optometrist
Primary
—
—
332H00000X
Eyewear Supplier
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
193518600
—
MN
Enumeration date
12/06/2006
Last updated
04/03/2023
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