| NPI | 1700113180 |
|---|---|
| Former Legal Business Name | PINECONE LASER CENTER |
| Entity Type | Organization |
| Authorized Contact | NICHOLAS COLATRELLA Owner 320-258-3915 |
| Organization Subpart ? | Yes |
| Primary Taxonomy | 152WV0400X Optometrist, Vision Therapy (Licence: MN 3067) |
| Enumeration Date | 2009-11-05 |
| Last Update Date | 2009-11-05 |