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General NPI Number Information
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NPI Number | 1992082382
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Entity Type | Organization
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Legal Business Name | PRECISION EYE CARE, LLC
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Dates
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Enumeration Date | 11/14/2011
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Last Update Date | 02/22/2012
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Provider Practice Location Address
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Address Line | 753 MARKETPLACE DRIVE
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City | WACONIA
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State | MN
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Zip | 55387
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Country | US
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Telephone | 952-442-2015
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Fax | 952-442-2070
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Provider Business Mailing Address
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Address Line | 8369 ALLEGHENY GROVE BLVD
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City | VICTORIA
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State | MN
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Zip | 55386-8240
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Country | US
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Telephone | 605-695-1256
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Fax |
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Authorized Official
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Title or Position | PRESIDENT
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Name | DR. HEATHER ANNE NOEL TUTTLE
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Credential | O.D.
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Telephone | 605-695-1256
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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 | 3092
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License Number State | MN
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