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General NPI Number Information
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NPI Number | 1215972617
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Entity Type | Organization
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Legal Business Name | RELF EYECARE SPECIALISTS PA
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Dates
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Enumeration Date | 06/19/2006
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Last Update Date | 08/12/2011
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Provider Practice Location Address
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Address Line | 4413 AIR BASE RD
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City | HERMANTOWN
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State | MN
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Zip | 55811-1847
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Country | US
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Telephone | 218-720-3553
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Fax | 218-786-9375
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Provider Business Mailing Address
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Address Line | 4413 AIR BASE RD
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City | HERMANTOWN
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State | MN
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Zip | 55811-1847
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Country | US
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Telephone | 218-720-3553
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Fax | 218-786-9375
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Authorized Official
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Title or Position | PRESIDENT
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Name | SUSAN J RELF
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Credential | MD
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Telephone | 218-720-3553
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207W00000X
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Taxonomy Name | Ophthalmology Physician
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License Number |
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License Number State |
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