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LEE NELSON O.D.
>> Optometrist >> Eye and Vision Services ProvidersRegistrant NPI Number: 1093102089
Individual Registrant: LEE NELSON O.D.
Gender: M
Not Sole Proprietor
Gender: M
Not Sole Proprietor
Location and contact information for practice:
13160 230TH ST N SCANDIA, MN 55073-9553 US
Tel: 651-503-4838 Fax: --
Tel: 651-503-4838 Fax: --
Contact information for business:
13160 230TH ST N SCANDIA, MN 55073-9553 US
Tel: 651-503-4838 Fax: --
Tel: 651-503-4838 Fax: --
Registration Information:
NPI: 1093102089
Entity Type: Individual
Entity Type: Individual
Specialty information:
| Primary | Code | Category/Description | State | License Number |
|---|---|---|---|---|
| Y | 152W00000X | Eye and Vision Services Providers Optometrist | MN | 1822 |
Legacy codes, insurance codes and state license numbers:
| Issuer | Number | State | Type |
|---|---|---|---|
