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Contact Information

MOOSE LAKE EYE CARE, LLC
45 LADY LUCK DR.
SUITE 120
HINCKLEY, MN55037
 Phone: 320-384-6361
 Fax: 320-384-6361
 Website:
 

Specialty

Taxonomy Code Specialty Code Provider Type

Optometrist

152W00000X 41 Optometry
Indicates primary specialty

NPI Profile & details for MOOSE LAKE EYE CARE LLC · (Female)

NPI Number 1700263985
Status Active
Credentials
Entity Individual
Enumeration date 04/27/2015
Last updated 04/27/2015 - About 11 years ago
Sole proprietor 1 Not specified
Identifiers
  • MN License # 152W00000X
  • MN Medicaid 1411674742
  • MN Other 1235188079 PROVIDER NPI
  • MN Other 1275582421 PROVIDER NPI
  • MN Other 1760558399 PROVIDER NPI
Hospital affiliation(s) Not Available
1 A sole proprietor/sole proprietorship is an individual, and as such, is eligible for a single NPI number. The sole proprietor must apply for the NPI number using his or her own Social Security Number (SSN), not an Employer Identification Number (EIN) even if he/she has an EIN.

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