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General NPI Number Information
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NPI Number | 1720239346
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Entity Type | Organization
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Legal Business Name | EIYNCK INC. DBA THE EYE NOOK
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Dates
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Enumeration Date | 10/01/2008
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Last Update Date | 11/11/2008
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Provider Practice Location Address
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Address Line | 825 NICOLLET MALL MEDICAL ARTS BLDG. SUITE 140
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City | MPLS
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State | MN
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Zip | 55402
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Country | US
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Telephone | 612-339-8009
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Fax | 612-339-8016
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Provider Business Mailing Address
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Address Line | 825 NICOLLET MALL MEDICAL ARTS BLDG SUITE 140
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City | MPLS
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State | MN
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Zip | 55402
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Country | US
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Telephone | 612-339-8009
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Fax | 612-339-8016
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Authorized Official
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Title or Position | OWNER/OPTICIAN
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Name | MR. AUGUST MICHEAL EIYNCK
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Credential |
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Telephone | 612-339-8009
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 332H00000X
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Taxonomy Name | Eyewear Supplier
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License Number |
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License Number State |
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