Provider Demographics
NPI:1750645115
Name:SCHMITZ, AMANDA (OD)
Entity Type:Individual
Prefix:DR
First Name:AMANDA
Middle Name:
Last Name:SCHMITZ
Suffix:
Gender:F
Credentials:OD
Other - Prefix:DR
Other - First Name:AMANDA
Other - Middle Name:
Other - Last Name:WOLDMOE
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:OD
Mailing Address - Street 1:3777 COON RAPIDS BLVD NW STE 100
Mailing Address - Street 2:
Mailing Address - City:COON RAPIDS
Mailing Address - State:MN
Mailing Address - Zip Code:55433-2630
Mailing Address - Country:US
Mailing Address - Phone:763-421-7420
Mailing Address - Fax:763-421-0730
Practice Address - Street 1:3777 COON RAPIDS BLVD NW STE 100
Practice Address - Street 2:
Practice Address - City:COON RAPIDS
Practice Address - State:MN
Practice Address - Zip Code:55433-2630
Practice Address - Country:US
Practice Address - Phone:763-421-7420
Practice Address - Fax:763-421-0730
Is Sole Proprietor?:No
Enumeration Date:2012-07-01
Last Update Date:2021-10-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MN3306152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152W00000XEye and Vision Services ProvidersOptometrist