Provider Demographics
NPI:1275919151
Name:AHMANN EYECARE PLLC
Entity Type:Organization
Organization Name:AHMANN EYECARE PLLC
Other - Org Name:OPTICAL OUTLOOK
Other - Org Type:Doing Business As
Authorized Official - Title/Position:OPTOMETRIST/OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:JESSICA
Authorized Official - Middle Name:
Authorized Official - Last Name:AHMANN
Authorized Official - Suffix:
Authorized Official - Credentials:OD
Authorized Official - Phone:701-837-0022
Mailing Address - Street 1:1100 31ST AVE SW STE 2
Mailing Address - Street 2:
Mailing Address - City:MINOT
Mailing Address - State:ND
Mailing Address - Zip Code:58701-2007
Mailing Address - Country:US
Mailing Address - Phone:701-837-0022
Mailing Address - Fax:
Practice Address - Street 1:1100 31ST AVE SW STE 2
Practice Address - Street 2:
Practice Address - City:MINOT
Practice Address - State:ND
Practice Address - Zip Code:58701-2007
Practice Address - Country:US
Practice Address - Phone:701-837-0022
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2015-08-03
Last Update Date:2023-11-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NDND663152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes152W00000XEye and Vision Services ProvidersOptometristGroup - Single Specialty