Organization
ASSOCIATED EYE CARE OPTICAL LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. STEPHEN S LANE M.D. (OWNER)
(651) 275-3000
Entity
Organization
Contact information
Practice address
1719 TOWER DR W STE 100, STILLWATER, MN 55082-7512
(651) 275-3050
(651) 275-3027
Mailing address
1719 TOWER DR W STE 100, STILLWATER, MN 55082-7512
(651) 275-3050
(651) 275-3027
Taxonomy
Speciality
Code
Description
License number
State
332H00000X
Eyewear Supplier
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
123400000
—
MN
05
—
366688000
—
MN
05
—
38444000
—
WI
05
—
466382900
—
MN
01
—
56062CR
BLUE CROSS BLUE SHIELD OF MN
MN
05
—
833062000
—
MN
05
—
866468400
—
MN
Enumeration date
08/06/2007
Last updated
06/12/2008
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