Glacial Ridge Eye Clinic, Inc.

NPI #1245356914 in Glenwood, Minnesota

Provider Information

NPI Number
1245356914
Entity Type
Organization
Organization Name
Glacial Ridge Eye Clinic, Inc.
Primary Specialty
Optometrist
Enumeration Date
Mar 22, 2007
Last Updated
Sep 6, 2007

Practice Location

Address
24 1ST ST SE
ZIP Code
56334-1619
Phone
(320) 634-4516

Authorized Official

Name
CRAIG D DEJONG
Title
OPTOMETRIST
Phone
(320) 634-4516

Specialties & Taxonomy Codes

Specialty
Optometrist

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