Healthcare Provider Details

I. General information

NPI: 1639115546
Provider Name (Legal Business Name): RELF OPTICAL LTD
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 06/20/2006
Last Update Date: 12/22/2010
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

5007 MATTERHORN DR
DULUTH MN
55811-3812
US

IV. Provider business mailing address

5007 MATTERHORN DR
DULUTH MN
55811-3812
US

V. Phone/Fax

Practice location:
  • Phone: 218-720-3553
  • Fax: 218-786-9375
Mailing address:
  • Phone: 218-720-3553
  • Fax: 218-786-9375

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code332H00000X
TaxonomyEyewear Supplier
License Number
License Number State

VIII. Authorized Official

Name: SUSAN J RELF
Title or Position: PRESIDENT
Credential: MD
Phone: 218-720-3553