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General NPI Number Information
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NPI Number | 1649864919
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Entity Type | Organization
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Legal Business Name | VANTAGE POINT EYES PLLC
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Dates
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Enumeration Date | 02/26/2021
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Last Update Date | 03/11/2021
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Provider Practice Location Address
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Address Line | 755 BIELENBERG DR STE 103
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City | WOODBURY
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State | MN
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Zip | 55125-4443
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Country | US
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Telephone | 651-504-5901
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Fax | 651-504-5902
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Provider Business Mailing Address
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Address Line | 755 BIELENBERG DR STE 103
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City | WOODBURY
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State | MN
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Zip | 55125-4443
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position | OPTOMETRIST/OWNER
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Name | DR. LISA JO HOLTMAN
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Credential | OD
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Telephone | 651-504-5901
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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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