Organization
ROSEVILLE OPTICIANS
Active
Parent organization
KENNEDY EYE ASSOCIATES
Organization subpart
Yes
Provider details
NPI number
Legal business name
KENNEDY EYE ASSOCIATES
Authorized official
ROBERT B KENNEDY O.D. (PRESIDENT)
(651) 489-8800
Entity
Organization
Contact information
Practice address
1790 LEXINGTON AVE N, SAINT PAUL, MN 55113-6167
(651) 489-8800
Mailing address
1790 LEXINGTON AVE N, SAINT PAUL, MN 55113-6167
(651) 489-8800
Taxonomy
Speciality
Code
Description
License number
State
156FX1800X
Optician
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
27620RO
BC/BS OF MN
MN
Enumeration date
08/19/2009
Last updated
08/19/2009
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