| NPI | 1982071825 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | ELLIOTT D BRUBAKER President/Optometrist 612-240-3814 |
| Organization Subpart ? | No |
| Primary Taxonomy | 152W00000X Optometrist (Licence: MN 2514) |
| Enumeration Date | 2015-08-26 |
| Last Update Date | 2015-08-26 |