Elbow Lake Eye Care Center

NPI #1407150485 in Elbow Lake, Minnesota

Provider Information

NPI Number: 1407150485
Entity Type: Organization
Organization Name: Elbow Lake Eye Care Center
Subpart: Yes (part of a larger organization)
Parent Organization: LAKE REGION HEALTHCARE
Primary Specialty: Optometrist
Enumeration Date: Jan 5, 2011
Last Updated: Jan 5, 2011

Practice Location

Address: 930 1ST ST NE # 101
City: Elbow Lake
State: Minnesota
ZIP Code: 56531-4611
Phone: (218) 685-4341

Authorized Official

Name: LISA JOHNSON
Title: MEDICAL STAFF SERVICES COORDINATOR
Phone: (218) 736-8477

Specialties & Taxonomy Codes

Specialty	Taxonomy Code	Primary
Optometrist	152W00000X	Primary

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