| |
870 Prentice St, Granite Falls, MN 56241-1521 | |
(320) 564-4997 | |
(320) 564-2020 |
Full Name | |
---|---|
Type | Facility |
Speciality | Optometrist |
Location | 870 Prentice St, Granite Falls, Minnesota |
Accepts Medicare Assignments | Medicare enrolled and accepts medicare insurance. Providers at this facility may prescribe medicare part D drugs. |
Identifier | Type | State | Issuer |
---|---|---|---|
1851445464 | NPI | - | NPPES |
645512300 | Medicaid | MN |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
152W00000X | Optometrist | 2337 (Minnesota) | Primary |
Provider Name | Todd E Trudel |
---|---|
Provider Type | Practitioner - Optometry |
Provider Identifiers | NPI Number: 1902850852 PECOS PAC ID: 4880665611 Enrollment ID: I20040805000663 |
Provider Name | Jacob Bollman |
---|---|
Provider Type | Practitioner - Optometry |
Provider Identifiers | NPI Number: 1811336043 PECOS PAC ID: 3274767454 Enrollment ID: I20131001000083 |
Provider Name | Kassidy Winther |
---|---|
Provider Type | Practitioner - Optometry |
Provider Identifiers | NPI Number: 1023852027 PECOS PAC ID: 8123559846 Enrollment ID: I20241007000286 |
Mailing Address | Practice Location Address |
---|---|
870 Prentice St, P.o. Box 127, Granite Falls, MN 56241-1521 Ph: (320) 564-4997 | 870 Prentice St, Granite Falls, MN 56241-1521 Ph: (320) 564-4997 |
Dr. Todd E Trudel, O.D. Optometrist Medicare: Accepting Medicare Assignments Practice Location: 870 Prentice St, Granite Falls, MN 56241 Phone: 320-564-4997 Fax: 320-564-2020 |