Richard David Bruesch, OD

NPI #1922119486 in Forest Lake, Minnesota

Provider Information

NPI Number: 1922119486
Entity Type: Individual
Name: Richard David Bruesch, OD
Gender: Not Specified
Sole Proprietor: Yes
Primary Specialty: Optometrist
Credential: OD
Enumeration Date: Aug 31, 2006
Last Updated: Jul 9, 2007

Practice Location

Address: 200 12TH ST SW
City: Forest Lake
State: Minnesota
ZIP Code: 55025-1482
Phone: (651) 464-9767

Specialties & Taxonomy Codes

Specialty	Taxonomy Code	Primary
Optometrist	152W00000X	Primary

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