Grange, Matthew William

Grange, Matthew William is an individual health care provider with primary practice located at 1340 Duckwood Dr Suite 14, Eagan MN 55123-2324. He recently has 5 registered licenses in different health care specialties including Eye and Vision Services Providers / Optometrist, Eye and Vision Services Providers / Corneal and Contact Management, Eye and Vision Services Providers / Pediatrics, Eye and Vision Services Providers / Sports Vision, Eye and Vision Services Providers / Occupational Vision. Eye and Vision Services Providers / Optometrist is his primary health care specialty. Grange, Matthew William can be contacted via phone (651) 452-0344.

Contact Information

Primary practice address
1340 Duckwood Dr Suite 14 Eagan MN 55123-2324
Fax: (651) 452-1564
Website:

Health care specialties

SpecialtyCodeLicense #State
Eye and Vision Services Providers / Optometrist 152W00000X 3020000 Minnesota
Eye and Vision Services Providers / Corneal and Contact Management 152WC0802X 3020000 Minnesota
Eye and Vision Services Providers / Pediatrics 152WP0200X 3020000 Minnesota
Eye and Vision Services Providers / Sports Vision 152WS0006X 3020000 Minnesota
Eye and Vision Services Providers / Occupational Vision 152WX0102X 3020000 Minnesota

Profile Details

NPI number 1427146372
LBN Legal business name Grange, Matthew William
Credentials Doctor of Optometry (OD)
Entity Individual
Sole proprietor 1 No
Enumeration date Oct 10th, 2006
Last updated Mar 7th, 2023 - about 2 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1427146372 NPPES
Other 2425242 AMERICAS PPO
Other 86G79GR AMERICAS PPO
Other XX1901044875 AMERICAS PPO
Other 2203255 AMERICAS PPO
Other HP60833 AMERICAS PPO
Other 182595 AMERICAS PPO

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