Provider Demographics
NPI:1447541453
Name:MIDWEST VISION CENTERS, INC
Entity type:Organization
Organization Name:MIDWEST VISION CENTERS, INC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:OFFICE ADMINISTRATOR
Authorized Official - Prefix:MRS
Authorized Official - First Name:CARI
Authorized Official - Middle Name:MARIE
Authorized Official - Last Name:EVANS
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:888-466-5777
Mailing Address - Street 1:PO BOX 456
Mailing Address - Street 2:
Mailing Address - City:SAINT CLOUD
Mailing Address - State:MN
Mailing Address - Zip Code:56302-0456
Mailing Address - Country:US
Mailing Address - Phone:888-466-5777
Mailing Address - Fax:320-258-3136
Practice Address - Street 1:990 W 41ST ST
Practice Address - Street 2:SUITE 54
Practice Address - City:HIBBING
Practice Address - State:MN
Practice Address - Zip Code:55746-3045
Practice Address - Country:US
Practice Address - Phone:218-263-8266
Practice Address - Fax:218-263-8224
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2011-04-25
Last Update Date:2011-04-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes152W00000XEye and Vision Services ProvidersOptometristGroup - Single Specialty