Provider Demographics
NPI:1053672857
Name:KAMINSKI, SARA SPEAR (OD)
Entity Type:Individual
Prefix:DR
First Name:SARA
Middle Name:SPEAR
Last Name:KAMINSKI
Suffix:
Gender:F
Credentials:OD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2507 LONE EAGLE TRL
Mailing Address - Street 2:
Mailing Address - City:WOODBURY
Mailing Address - State:MN
Mailing Address - Zip Code:55129-4207
Mailing Address - Country:US
Mailing Address - Phone:651-354-1425
Mailing Address - Fax:
Practice Address - Street 1:449 COMMERCE DRIVE
Practice Address - Street 2:
Practice Address - City:WOODBURY
Practice Address - State:MN
Practice Address - Zip Code:55129-4207
Practice Address - Country:US
Practice Address - Phone:651-354-1425
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2012-06-07
Last Update Date:2017-06-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MN3281152W00000X, 152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152W00000XEye and Vision Services ProvidersOptometrist