| NPI | 1508177890 |
|---|---|
| Doing Business As | AVERA MEDICAL GROUP OPTOMETRY MOUNTAIN LAKE |
| Entity Type | Organization |
| Authorized Contact | DEBBIE STREIER CEO 507-537-9160 |
| Organization Subpart ? | No |
| Primary Taxonomy | 152W00000X Optometrist |
| Additional Taxonomies | 207W00000X Ophthalmology |
| 332B00000X Durable Medical Equipment & Medical Supplies | |
| Enumeration Date | 2010-07-01 |
| Last Update Date | 2022-12-02 |