| NPI | 1629254867 |
|---|---|
| Doing Business As | ADVANCED OPTICAL |
| Entity Type | Organization |
| Authorized Contact | JEFFREY DAVID MELICHER President 218-744-3288 |
| Organization Subpart ? | No |
| Primary Taxonomy | 152W00000X Optometrist (Licence: MN MN 2409) |
| Additional Taxonomies | 156FX1800X Technician/Technologist, Optician |
| Enumeration Date | 2008-01-17 |
| Last Update Date | 2012-02-10 |