Tesha Gustafson, O.D.

NPI #1467807230 in Kenmare, North Dakota

Provider Information

NPI Number: 1467807230
Entity Type: Individual
Name: Tesha Gustafson, O.D.
Gender: Not Specified
Sole Proprietor: No
Primary Specialty: Optometrist
Credential: O.D.
Enumeration Date: Apr 29, 2016
Last Updated: Feb 4, 2019

Practice Location

Address: 28 2ND ST NW
City: Kenmare
State: North Dakota
ZIP Code: 58746-7114
Phone: (701) 385-4004

Specialties & Taxonomy Codes

Specialty	Taxonomy Code	Primary
Optometrist	152W00000X	Primary

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