1815 Vision LLC
Organization Active NPI Optometrist · Brooklyn Center, MN
NPI 1992460166 · NPPES record last updated Nov 3, 2021
Key facts
- NPI
- 1992460166
- Entity type
- Organization (NPI type 2)
- Primary specialty
- Optometrist 152W00000X
- Legal business name
- 1815 VISION LLC
- Practice address
- 5515 Xerxes Ave N
Brooklyn Center, MN 55430-2856 - Phone
- (763) 560-1636
- NPI assigned
- Nov 3, 2021
- Organization subpart
- No
Authorized official
- Name
- James Hawley
- Title
- Owner
- Phone
- (612) 599-0153
National Provider Directory
Locations
13195 Weaver Lake Rd
Maple Grove, MN 55369
Phone (763) 420-5112
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Optometrist |
152W00000X | Yes |
Addresses
Primary practice location
5515 Xerxes Ave N
Brooklyn Center, MN 55430-2856
Mailing address
13195 Weaver Lake Rd
Maple Grove, MN 55369-9410
Phone (763) 420-5112
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Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Nov 3, 2021. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.