Northwest Eye Clinic, LLC

NPI #1891871646 in Wayzata, Minnesota

Provider Information

NPI Number
1891871646
Entity Type
Organization
Organization Name
Northwest Eye Clinic, LLC
Primary Specialty
Ophthalmology
Enumeration Date
Oct 27, 2006
Last Updated
Mar 18, 2020

Practice Location

Address
250 CENTRAL AVE N STE 107
ZIP Code
55391-1207
Phone
(763) 416-7600

Authorized Official

Name
KELLY PETTENGILL
Title
CREDENTIALING AND DATA MANAGEMENT
Phone
(763) 416-7629

Specialties & Taxonomy Codes

Specialty
Ophthalmology

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