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1316102643
SARA RAE BETTERLY WALLEN
PRIOR LAKE, MN
NPI
1316102643
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Former Name
SARA RAE BETTERLY
Entity Type
Individual
Gender
Female
Sole Proprietor ?
No
Primary Taxonomy
152W00000X Optometrist
(Licence: MN 3116)
Enumeration Date
2008-07-25
Last Update Date
2008-07-25
Business Address
Dr. SARA RAE BETTERLY WALLEN
2330 SIOUX TRL NW
PRIOR LAKE, MN 55372-9077
Phone number: 952-233-2955
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Mailing Address
Dr. SARA RAE BETTERLY WALLEN
712 HAGUE AVE APT 2
SAINT PAUL, MN 55104-6951
Phone number: 651-210-6202
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