| NPI | 1992755920 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | KAY LYNETTE GUNNARSON Office Manager/Owner 218-829-2929 |
| Organization Subpart ? | No |
| Primary Taxonomy | 152W00000X Optometrist (Licence: MN MN1980) |
| Additional Taxonomies | 152W00000X Optometrist |
| Enumeration Date | 2006-05-11 |
| Last Update Date | 2014-02-21 |