NPI 1922347848

Jayden2006

Organisation Optician Maple Grove, MN

Practice location

Address: 13195 Weaver Lake Rd, Maple Grove, MN 55369-9410
Phone: (612) 599-0153
Mailing address: 12256 Lakeview Drive N, Maple Grove, MN 55369

Authorised official

Name: James Hawley
Title: President
Phone: (612) 599-0153

Registered specialties

Optician Primary

Eye and Vision Services Providers Taxonomy 156FX1800X

Other Technician/Technologist providers in Minnesota →

Registry record

NPI: 1922347848
Entity type: Organization
NPI issued: 13 Feb 2013
Record last updated: 13 Feb 2013

Reproduced from NPPES, the federal provider registry. The date above is when the provider last updated their own entry, not when we fetched it - a record can be years old and still current in the registry.