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General NPI Number Information
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NPI Number | 1942253653
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Entity Type | Organization
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Legal Business Name | SAINT ANTHONY OPTICAL LTD.
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Dates
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Enumeration Date | 05/17/2006
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Last Update Date | 08/31/2007
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Provider Practice Location Address
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Address Line | 2353 RICE ST STE. 206
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City | ROSEVILLE
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State | MN
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Zip | 55113-3739
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Country | US
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Telephone | 651-483-8148
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Fax | 651-483-3206
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Provider Business Mailing Address
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Address Line | PO BOX 130848
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City | ROSEVILLE
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State | MN
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Zip | 55113-0008
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Country | US
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Telephone | 651-483-8148
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Fax | 651-483-3206
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Authorized Official
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Title or Position | PRESIDENT
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Name | MR. RICHARD EARL LAPPI
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Credential | COMT
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Telephone | 651-483-8148
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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 | 2594
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License Number State | MN
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