Provider Demographics
NPI:1053557256
Name:ALL EYES PLLC
Entity type:Organization
Organization Name:ALL EYES PLLC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:O.D./OWNER/MANAGER
Authorized Official - Prefix:DR
Authorized Official - First Name:JOYCE
Authorized Official - Middle Name:MARIE
Authorized Official - Last Name:SCHANZENBACH
Authorized Official - Suffix:
Authorized Official - Credentials:OD
Authorized Official - Phone:952-447-2166
Mailing Address - Street 1:14655 QUEBEC PL
Mailing Address - Street 2:
Mailing Address - City:SAVAGE
Mailing Address - State:MN
Mailing Address - Zip Code:55378-2568
Mailing Address - Country:US
Mailing Address - Phone:952-447-2166
Mailing Address - Fax:952-445-8096
Practice Address - Street 1:8101 OLD CARRIAGE COURT
Practice Address - Street 2:
Practice Address - City:SHAKOPEE
Practice Address - State:MN
Practice Address - Zip Code:55379-3155
Practice Address - Country:US
Practice Address - Phone:952-445-8092
Practice Address - Fax:952-445-8096
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-12-18
Last Update Date:2017-12-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MN2603152W00000X
152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes152W00000XEye and Vision Services ProvidersOptometristGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
MN819003800Medicaid
MN410002097Medicare PIN
MNU66643Medicare UPIN