| NPI | 1790830701 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | NICHOLAS COLATRELLA Medical Director 320-258-3915 |
| Organization Subpart ? | No |
| Primary Taxonomy | 152W00000X Optometrist (Licence: MN 2617) |
| Enumeration Date | 2007-01-23 |
| Last Update Date | 2022-06-28 |