IndividualActive
Cody Mackenzie, ABOC
NPI 1679257398 · Optician · Saint Paul, MN
Provider details
- NPI number
- 1679257398
- Entity type
- Individual
- Primary specialty
- OpticianEye and Vision Services Providers
- Credential
- ABOC
- Sex
- Male
- Sole proprietor
- Yes
- License
- 237912 (MN)
Specialties & taxonomies
Eye and Vision Services Providers
Practice location
506 7th St W
Saint Paul, MN 55102-3049
Phone: (651) 333-4420
Approximate (ZIP-level) locationGet directions
Mailing address
506 7th St W
Saint Paul, MN 55102-3049
Registry dates
- Enumerated
- 2023-06-13
- Last updated
- 2023-06-13
- Certified
- 2023-06-13
Source: CMS NPPES Data Dissemination (June 2026). NPI Central is not affiliated with CMS. Data is provided as-is from the public registry.