Healthcare Provider Details
I. General information
NPI: 1033439708
Provider Name (Legal Business Name): STRINDEN VISION INC
Entity Type: Organization
Gender:
Sole Proprietor:
II. Dates (important events)
Enumeration Date: 06/04/2010
Last Update Date: 06/04/2010
Certification Date:
Deactivation Date:
Reactivation Date:
III. Provider practice location address
3221 32ND AVE S
GRAND FORKS ND
58201-6071
US
IV. Provider business mailing address
3221 32ND AVE S
GRAND FORKS ND
58201-6071
US
V. Phone/Fax
- Phone: 701-780-9701
- Fax: 701-780-9084
- Phone: 701-780-9701
- Fax: 701-780-9084
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 152W00000X |
| Taxonomy | Optometrist |
| License Number | |
| License Number State | |
VIII. Authorized Official
Name:
THOMAS
I
STRINDEN
Title or Position: OWNER
Credential: MD
Phone: 701-293-8242