Vandesteeg & Larson Optometric Clinic, PA
Optometrist in Long Prairie, MN. Organization (NPI-2).
NPI number1669944104
StatusActive
Last updated in NPPESDec 21, 2018
Details
- NPI
- 1669944104
- Entity type
- Organization (NPI-2)
- Legal business name
- Vandesteeg & Larson Optometric Clinic, PA
- Organization subpart
- Yes
- Enumeration date
- Dec 21, 2018
- Last updated
- Dec 21, 2018
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 152W00000X | Optometrist | – | – | Yes |
Practice location
240 Central AveLong Prairie, MN 56347
Phone 320-732-2313 · Fax 320-533-3147
Mailing address
240 Central AveLong Prairie, MN 56347
Phone 320-732-2313 · Fax 320-533-3147
Authorized official
Stephen M Larson
President
3207322313
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