Provider Demographics
NPI:1063151686
Name:LOERZEL EYE CARE, LLC
Entity type:Organization
Organization Name:LOERZEL EYE CARE, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MANAGING MEMBER
Authorized Official - Prefix:
Authorized Official - First Name:REBECCA
Authorized Official - Middle Name:
Authorized Official - Last Name:LOERZEL
Authorized Official - Suffix:
Authorized Official - Credentials:OD
Authorized Official - Phone:612-414-4258
Mailing Address - Street 1:9451 MAPLE GROVE PKWY
Mailing Address - Street 2:
Mailing Address - City:MAPLE GROVE
Mailing Address - State:MN
Mailing Address - Zip Code:55311-5447
Mailing Address - Country:US
Mailing Address - Phone:763-416-2312
Mailing Address - Fax:763-416-2314
Practice Address - Street 1:9451 MAPLE GROVE PKWY
Practice Address - Street 2:
Practice Address - City:MAPLE GROVE
Practice Address - State:MN
Practice Address - Zip Code:55311-5447
Practice Address - Country:US
Practice Address - Phone:763-416-2312
Practice Address - Fax:763-416-2314
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2022-06-01
Last Update Date:2022-11-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes156FX1800XEye and Vision Services ProvidersTechnician/TechnologistOpticianGroup - Single Specialty