| |
24 1st St Se, Glenwood, MN 56334-1619 | |
(320) 634-4516 | |
(320) 634-4520 |
Full Name | |
---|---|
Type | Facility |
Speciality | Eyewear Supplier |
Location | 24 1st St Se, Glenwood, Minnesota |
Accepts Medicare Assignments | Does not participate in Medicare Program. The facility may not accept medicare assignment. |
Identifier | Type | State | Issuer |
---|---|---|---|
1922401694 | NPI | - | NPPES |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
152W00000X | Optometrist | 1709 (Minnesota) | Secondary |
332H00000X | Eyewear Supplier | (* (Not Available)) | Primary |
Mailing Address | Practice Location Address |
---|---|
24 1st St Se, Glenwood, MN 56334-1619 Ph: (320) 634-4516 | 24 1st St Se, Glenwood, MN 56334-1619 Ph: (320) 634-4516 |