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NPI 1134155419

NPI 1134155419 : CAMBRIDGE EYE ASSOCIATES, P.A. : CAMBRIDGE, MN

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General NPI Number Information
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    NPI Number           |    1134155419
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    Entity Type          |    Organization 
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    Legal Business Name  |    CAMBRIDGE EYE ASSOCIATES, P.A. 
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Dates
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    Enumeration Date     |    06/25/2006
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    Last Update Date     |    02/04/2010
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Provider Practice Location Address
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    Address Line         |    120 1ST AVE E 
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    City                 |    CAMBRIDGE
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    State                |    MN
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    Zip                  |    55008-1209
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    Country              |    US
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    Telephone            |    763-689-1494
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    Fax                  |    763-691-8395
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Provider Business Mailing Address
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    Address Line         |    120 1ST AVE E 
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    City                 |    CAMBRIDGE
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    State                |    MN
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    Zip                  |    55008-1209
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    Country              |    US
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    Telephone            |    763-689-1494
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    Fax                  |    763-691-8395
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Authorized Official
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    Title or Position    |    PRESIDENT
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    Name                 |    DR. CHADWICK AARON CHRISTENSON 
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    Credential           |    O.D.
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    Telephone            |    763-689-1494
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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    Taxonomy Code        |    152W00000X
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    Taxonomy Name        |    Optometrist
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    License Number       |    
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    License Number State |    
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