| NPI | 1053351817 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | TIMOTHY CHARLES BONNER President 218-326-3343 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207W00000X Ophthalmology (Licence: MN 432) |
| Additional Taxonomies | 152W00000X Optometrist (Licence: MN 432) |
| Enumeration Date | 2006-06-08 |
| Last Update Date | 2007-10-17 |