| NPI | 1063457943 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | GARY MARK HOFFARD President 763-441-1055 |
| Organization Subpart ? | No |
| Primary Taxonomy | 152W00000X Optometrist |
| Additional Taxonomies | 152WC0802X Optometrist Corneal and Contact Management |
| 156FX1800X Technician/Technologist Optician | |
| Enumeration Date | 2006-06-17 |
| Last Update Date | 2010-08-06 |