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General NPI Number Information
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NPI Number | 1316955941
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Entity Type | Organization
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Legal Business Name | WHELAN EYE CARE, INC.
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Dates
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Enumeration Date | 08/03/2006
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Last Update Date | 04/02/2025
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Provider Practice Location Address
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Address Line | 1900 DIVISION ST W UNIT 5
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City | BEMIDJI
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State | MN
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Zip | 56601-6397
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Country | US
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Telephone | 218-759-1430
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Fax | 218-444-9086
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Provider Business Mailing Address
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Address Line | 1900 DIVISION ST W
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City | BEMIDJI
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State | MN
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Zip | 56601-6396
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Country | US
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Telephone | 218-759-1430
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Fax | 218-444-9086
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Authorized Official
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Title or Position | OPTOMETRIST/PRESIDENT
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Name | LAUREN HAZELTON
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Credential |
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Telephone | 907-306-8300
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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 | 2110
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License Number State | MN
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