| NPI | 1700409885 |
|---|---|
| Doing Business As | CANNON EYE CLINIC |
| Entity Type | Organization |
| Authorized Contact | RUSSELL NATHANIEL OSNES President/Owner 651-452-0344 |
| Organization Subpart ? | Yes |
| Primary Taxonomy | 152W00000X Optometrist |
| Enumeration Date | 2020-05-22 |
| Last Update Date | 2020-05-22 |