South Suburban Eyecare Specialists PA

NPI #1407059678 in Lakeville, Minnesota

Provider Information

NPI Number: 1407059678
Entity Type: Organization
Organization Name: South Suburban Eyecare Specialists PA
Primary Specialty: Optometrist
Enumeration Date: Jun 6, 2007
Last Updated: Jun 2, 2011

Practice Location

Address: 17690 KENWOOD TRL
City: Lakeville
State: Minnesota
ZIP Code: 55044-9764
Phone: (952) 898-9588

Authorized Official

Name: DR. ANDREW JOSEPH MATTSON, OD
Title: PRESIDENT
Phone: (952) 898-9588

Specialties & Taxonomy Codes

Specialty	Taxonomy Code	Primary
Optometrist	152W00000X	Primary

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