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General NPI Number Information
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NPI Number | 1235152224
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Entity Type | Organization
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Legal Business Name | KASSON EYE CARE PA
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Dates
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Enumeration Date | 07/25/2006
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Last Update Date | 11/29/2007
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Provider Practice Location Address
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Address Line | 504 S MANTORVILLE AVENUE STE 1
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City | KASSON
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State | MN
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Zip | 55944-2207
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Country | US
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Telephone | 507-634-4445
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Fax | 507-634-7940
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Provider Business Mailing Address
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Address Line | 504 S MANTORVILLE AVENUE STE 1
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City | KASSON
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State | MN
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Zip | 55944-2207
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Country | US
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Telephone | 507-634-4445
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Fax | 507-634-7940
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Authorized Official
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Title or Position | OWNER CEO
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Name | DR. CHRISTINE A LESKA
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Credential | OD
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Telephone | 507-634-4445
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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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