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General NPI Number Information
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NPI Number | 1972937506
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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 | 08/30/2013
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Last Update Date | 08/20/2025
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Provider Practice Location Address
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Address Line | 5366 386TH ST NE
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City | NORTH BRANCH
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State | MN
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Zip | 55056-5833
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Country | US
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Telephone | 651-674-6844
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Fax | 651-674-6845
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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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