Eagan Eye Clinic LLC

NPI #1528665544 in Saint Cloud, Minnesota

Provider Information

NPI Number: 1528665544
Entity Type: Organization
Organization Name: Eagan Eye Clinic LLC
Subpart: Yes (part of a larger organization)
Parent Organization: EAGAN EYE CLINIC LLC
Primary Specialty: Optometrist
Enumeration Date: Oct 2, 2020
Last Updated: Oct 2, 2020

Practice Location

Address: 1545 NORTHWAY DR STE 120
City: Saint Cloud
State: Minnesota
ZIP Code: 56303-1941
Phone: (320) 253-2441

Authorized Official

Name: BENJAMIN S. CHUDNER, OD
Title: PRESIDENT
Phone: (972) 370-5552

Specialties & Taxonomy Codes

Specialty	Taxonomy Code	Primary
Optometrist	152W00000X	Primary

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