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301 Lake Street, Warroad, MN 56763 | |
(218) 386-2081 | |
Not Available |
Full Name | |
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Type | Facility |
Speciality | Optometrist |
Location | 301 Lake Street, Warroad, Minnesota |
Accepts Medicare Assignments | Medicare enrolled and accepts medicare insurance. Providers at this facility may prescribe medicare part D drugs. |
Identifier | Type | State | Issuer |
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1669875514 | NPI | - | NPPES |
Taxonomy | Type | License (State) | Status |
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152W00000X | Optometrist | (* (Not Available)) | Primary |
Provider Name | Ross J Olson |
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Provider Type | Practitioner - Optometry |
Provider Identifiers | NPI Number: 1790071132 PECOS PAC ID: 6709055049 Enrollment ID: I20110803000363 |
Provider Name | Peter L Vatnsdal |
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Provider Type | Practitioner - Optometry |
Provider Identifiers | NPI Number: 1639430689 PECOS PAC ID: 1355599986 Enrollment ID: I20120924000382 |
Mailing Address | Practice Location Address |
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306 Main Ave N, Roseau, MN 56751-1820 Ph: (218) 463-2020 | 301 Lake Street, Warroad, MN 56763 Ph: (218) 386-2081 |