OrganizationActive
Birch Lake Vision Group, LLC.
NPI 1609921899 · Optometrist · White Bear Lake, MN
Provider details
- NPI number
- 1609921899
- Entity type
- Organization
- Primary specialty
- OptometristEye and Vision Services Providers
- Organization subpart
- No
- Authorized official
- Brian Grudem, Cfo(651) 426-2747
- License
- LD2695000 (MN)
Specialties & taxonomies
Eye and Vision Services Providers
Eye and Vision Services Providers
Practice location
4720 White Bear Pkwy
White Bear Lake, MN 55110-3336
Phone: (651) 426-2747
Fax: (651) 426-9838
Approximate (ZIP-level) locationGet directions
Mailing address
4720 White Bear Pkwy
White Bear Lake, MN 55110-3336
Other names (DBA / former)
- Doing business as
- Birch Lake Eye Clinic, Oak Tree Optical, Village Eye Clinic and Optica
Registry dates
- Enumerated
- 2007-01-25
- Last updated
- 2009-12-02
Source: CMS NPPES Data Dissemination (June 2026). NPI Central is not affiliated with CMS. Data is provided as-is from the public registry.