Lost Lake Optical Company
Lost Lake Optical Company is a Clinic/Center in Mound, Minnesota. Registered with an NPI since 2020.
- In the registry since
- 2020
Practice location Address checks out
5240 Shady Island CirMound, MN 55364-9222
Phone: (612) 670-8887
Fax: (952) 474-1933
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Pin is approximate — placed at the ZIP-code centre, not the exact door.
Specialties & licences
| Clinic/Center (primary) | Taxonomy 261Q00000X |
|---|
Record details
| NPI number | 1003434622 |
|---|---|
| Entity type | Organization (Type 2) |
| Organization subpart | No |
| Authorized official | Jay Petersen — Owner · (612) 670-8887 |
| NPI enumerated | July 9, 2020 |
| Last updated in NPPES | September 4, 2020 |
| Certification date | September 4, 2020 |
| Mailing address | 5240 Shady Island Cir, Mound, MN 55364-9222 |