Healthcare Provider Details

I. General information

NPI: 1265678056
Provider Name (Legal Business Name): STRINDEN VISION
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 12/28/2008
Last Update Date: 05/03/2010
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3221 32ND AVE S SUITE 300
GRAND FORKS ND
58201-6071
US

IV. Provider business mailing address

3221 32ND AVE S SUITE 300
GRAND FORKS ND
58201-6071
US

V. Phone/Fax

Practice location:
  • Phone: 701-780-9701
  • Fax: 701-780-9084
Mailing address:
  • Phone: 701-780-9701
  • Fax: 701-780-9084

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261QH0100X
TaxonomyHealth Service Clinic/Center
License Number
License Number State

VIII. Authorized Official

Name: DAVID ALLAN PEDERSON
Title or Position: OWNER
Credential:
Phone: 701-780-9701