| NPI | 1629148614 |
|---|---|
| Doing Business As | ANNANDALE EYE CLINIC |
| Entity Type | Organization |
| Authorized Contact | TERRENCE LEE TANCABEL Owner 320-274-3701 |
| Organization Subpart ? | No |
| Primary Taxonomy | 152W00000X Optometrist (Licence: MN 1765) |
| Enumeration Date | 2006-11-08 |
| Last Update Date | 2020-08-22 |