NPI | 1760674782 |
---|---|
Doing Business As | PEARLE VISION WILLMAR |
Entity Type | Organization |
Authorized Contact | BRADLEY L BACKHAUS CEO 320-235-1235 |
Organization Subpart ? | No |
Primary Taxonomy | 261Q00000X Clinic/Center (Licence: MN 2069) |
Enumeration Date | 2007-08-14 |
Last Update Date | 2008-11-05 |