| |
12700 Lake Blvd, Lindstrom, MN 55045 | |
(651) 257-2419 | |
(651) 257-2419 |
Full Name | |
---|---|
Type | Facility |
Speciality | Optometrist |
Location | 12700 Lake Blvd, Lindstrom, Minnesota |
Accepts Medicare Assignments | Does not participate in Medicare Program. The facility may not accept medicare assignment. |
Identifier | Type | State | Issuer |
---|---|---|---|
1831356773 | NPI | - | NPPES |
59389LO | Other | MN | BLUE CROSS BLUE SHIELD |
628823500 | Medicaid | MN | |
1861534315 | Other | MN | HEALTHPARTNERS |
45964 | Other | MN | PREFERREDONE |
2214338 | Other | MN | MEDICA |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
152W00000X | Optometrist | 2142 (Minnesota) | Primary |
Mailing Address | Practice Location Address |
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12700 Lake Blvd, Box 552, Lindstrom, MN 55045 Ph: (651) 257-2419 | 12700 Lake Blvd, Lindstrom, MN 55045 Ph: (651) 257-2419 |
Dr. Vernon Bruce Lovdokken, OD Optometrist Medicare: May Accept Medicare Assignments Practice Location: 12700 Lake Boulevard, Lindstrom, MN 55045 Phone: 651-257-2419 Fax: 651-257-2419 |