| NPI | 1811975931 |
|---|---|
| Doing Business As | BLUSTIN OPTICAL CENTER |
| Entity Type | Organization |
| Authorized Contact | DERIN JOHN VAN LOON Owner Optometrist 218-727-1004 |
| Organization Subpart ? | No |
| Primary Taxonomy | 152W00000X Optometrist |
| Enumeration Date | 2006-01-09 |
| Last Update Date | 2008-07-07 |