| |
424 Barclay Ave., Pine River, MN 56474-0457 | |
(218) 587-2020 | |
(218) 587-3229 |
Full Name | |
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Type | Facility |
Speciality | Optometrist |
Location | 424 Barclay Ave., Pine River, Minnesota |
Accepts Medicare Assignments | Does not participate in Medicare Program. The facility may not accept medicare assignment. |
Identifier | Type | State | Issuer |
---|---|---|---|
1124035191 | NPI | - | NPPES |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
152W00000X | Optometrist | 1895 (Minnesota) | Primary |
Mailing Address | Practice Location Address |
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Po Box 457, Pine River, MN 56474-0457 Ph: (218) 587-2020 | 424 Barclay Ave., Pine River, MN 56474-0457 Ph: (218) 587-2020 |
Michael S Marvin, O.D. Optometrist Medicare: Accepting Medicare Assignments Practice Location: 424 Barclay Ave, Pine River, MN 56474 Phone: 218-587-2020 Fax: 218-587-3229 |