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NPI Code Detail

MEDICARE: BECHTHOLD EYE CARE PA

MEDICARE: BECHTHOLD EYE CARE PA
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1152W00000XOptometrist

General Provider Information

NPI Number : 1881259794
Entity Type Code : Organization
Provider Name (Legal Business Name) : BECHTHOLD EYE CARE PA
Provider Business Mailing Address
First Line : 11 1ST AVE NW
Second Line :
City : CHISHOLM
State : MN
Zip : 55719-1811
Country : US
Telephone Number : 218-254-4393
Fax Number :
Provider Business Practice Location Address
First Line : 11 1ST AVE NW
Second Line :
City : CHISHOLM
State : MN
Zip : 55719-1811
Country : US
Telephone Number : 218-254-4393
Fax Number :
Authorized Official
Title or Position : OWNER
Name : KAYLA BECHTHOLD
Credential : OD
Telephone Number : 218-348-2658
Provider Enumeration Date : 05/06/2019
Last Update Date : 08/14/2019

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Directions to “BECHTHOLD EYE CARE PA ” Practice Location

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