Maple Grove Vision Clinic, P.A.

LBN: Maple Grove Vision Clinic, P.A.
Maple Grove Vision Clinic, P.A. is an health care organization with primary practice located at 13645 Grove Dr , Maple Grove MN 55311-4405. The organization recently has only one registered license in Eye and Vision Services Providers / Optometrist, which is considered as the primary health care specialty. Maple Grove Vision Clinic, P.A. can be contacted via phone (763) 420-8030, or through Thiel, Linda M via phone (763) 420-8030.

Contact Information

Primary practice address
13645 Grove Dr Maple Grove MN 55311-4405
Phone: (763) 420-8030
Fax: (763) 420-8342
Website:
Map and Directions
Authorized official contact:
Name: Thiel, Linda M
Phone: (763) 420-8030

Health care specialties

SpecialtyCodeLicense #State
Eye and Vision Services Providers / Optometrist 152W00000X

Profile Details

NPI number 1366472342
LBN Legal business name Maple Grove Vision Clinic, P.A.
DBA Doing business as
Authorized official Thiel, Linda M
Entity Organization
Organization subpart 1 No
Enumeration date Jul 4th, 2006
Last updated Aug 31st, 2009 - about 15 years ago

1 Some organizations, which are providing health care services, may consist of units or departments that provide different types of health care services or have several separate physical locations, where health care service is provided. These units, departments or physical locations are not themselves legal entities. However, each of them is part of the organization, which is a legal entity. The organization may decide whether its subparts, if it has any, should have their own NPI numbers. In case a subpart conducts any HIPAA standard transactions by itself, without its parent's involvement, it must have its own NPI number.

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Identifiers

StateTypeNumberIssuer
All States NPI 1366472342 NPPES
Minnesota MEDICAID 762603700

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