Provider Demographics
NPI:1750762977
Name:DOWNTOWN EYES OPTOMETRIC PLLC
Entity type:Organization
Organization Name:DOWNTOWN EYES OPTOMETRIC PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OPTOMETRIST
Authorized Official - Prefix:DR
Authorized Official - First Name:MARY ANN
Authorized Official - Middle Name:JOY
Authorized Official - Last Name:ZASTROW
Authorized Official - Suffix:
Authorized Official - Credentials:OD
Authorized Official - Phone:507-210-0469
Mailing Address - Street 1:800 NICOLLET MALL STE 260
Mailing Address - Street 2:
Mailing Address - City:MINNEAPOLIS
Mailing Address - State:MN
Mailing Address - Zip Code:55402-7023
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:800 NICOLLET MALL STE 260
Practice Address - Street 2:
Practice Address - City:MINNEAPOLIS
Practice Address - State:MN
Practice Address - Zip Code:55402-7023
Practice Address - Country:US
Practice Address - Phone:612-333-3937
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2015-06-12
Last Update Date:2018-03-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MN3211152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes152W00000XEye and Vision Services ProvidersOptometristGroup - Single Specialty