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1184002784
OPTIOVILLAGE, INC
ANOKA, MN
NPI
1184002784
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Entity Type
Organization
Authorized Contact
TRENTON JON PETERSON
Clinical Director
763-712-1903
Organization Subpart ?
No
Primary Taxonomy
251S00000X
Enumeration Date
2015-05-14
Last Update Date
2015-05-14
Business Address
OPTIOVILLAGE, INC
630 E MAIN ST
ANOKA, MN 55303-2527
Phone number: 763-712-1903
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Mailing Address
OPTIOVILLAGE, INC
630 EAST MAIN ST.
ANOKA, MN 55303
Phone number: 763-712-1903
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