| NPI | 1891965562 |
|---|---|
| Doing Business As | PELICAN RIVER OPTICAL |
| Entity Type | Organization |
| Authorized Contact | BRUCE DONALD NELSON Optician/Owner 218-847-5663 |
| Organization Subpart ? | No |
| Primary Taxonomy | 332H00000X Eyewear Supplier (Equipment, not the service) |
| Enumeration Date | 2008-03-09 |
| Last Update Date | 2008-07-16 |