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NPI 1912332271

NPI 1912332271 : TOTAL EYE CARE LLC : BLAINE, MN

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General NPI Number Information
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    NPI Number           |    1912332271
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    Entity Type          |    Organization 
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    Legal Business Name  |    TOTAL EYE CARE LLC 
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Dates
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    Enumeration Date     |    09/05/2013
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    Last Update Date     |    08/20/2025
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Provider Practice Location Address
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    Address Line         |    10961 CLUB WEST PKWY SUITE 130
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    City                 |    BLAINE
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    State                |    MN
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    Zip                  |    55449-5866
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    Country              |    US
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    Telephone            |    763-571-7550
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    Fax                  |    763-253-4142
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Provider Business Mailing Address
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    Address Line         |    11725 STINSON AVE 
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    City                 |    CHISAGO CITY
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    State                |    MN
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    Zip                  |    55013-9542
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    Country              |    US
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    Telephone            |    651-257-8421
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    Fax                  |    651-257-8464
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Authorized Official
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    Title or Position    |    BUSINESS OFFICE MANAGER
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    Name                 |     BETHANY  ROBERTS 
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    Credential           |    
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    Telephone            |    651-213-3369
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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       |    0193
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    License Number State |    MN
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