| NPI | 1477728418 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | LAWRENCE A RUDOLPH Pres O PT Ician 320-252-9380 |
| Organization Subpart ? | No |
| Primary Taxonomy | 156FX1800X Technician/Technologist Optician |
| Additional Taxonomies | 332BC3200X Durable Medical Equipment & Medical Supplies Customized Equipment |
| Enumeration Date | 2008-04-29 |
| Last Update Date | 2014-03-27 |