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General NPI Number Information
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NPI Number | 1952820045
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Entity Type | Organization
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Legal Business Name | GERARD EYE CO. ,PA
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Dates
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Enumeration Date | 09/11/2017
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Last Update Date | 11/28/2017
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Provider Practice Location Address
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Address Line | 12455 RIDGEDALE DR STE 101
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City | MINNETONKA
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State | MN
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Zip | 55305-1787
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Country | US
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Telephone | 952-545-6010
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Fax |
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Provider Business Mailing Address
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Address Line | 12455 RIDGEDALE DR STE 101
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City | MINNETONKA
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State | MN
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Zip | 55305-1787
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Country | US
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Telephone | 952-545-6010
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Fax | 952-252-0999
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Authorized Official
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Title or Position | OPTOMETRIST/OWNER
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Name | DR. ARA GERARD
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Credential | OD
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Telephone | 952-240-2643
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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 | 2882
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License Number State | MN
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