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General NPI Number Information
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NPI Number | 1225603509
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Entity Type | Organization
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Legal Business Name | STEEL OPTICAL INC PROFESSIONAL CORPORATION
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Dates
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Enumeration Date | 05/20/2021
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Last Update Date | 05/20/2021
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Provider Practice Location Address
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Address Line | 995 BLUE GENTIAN RD
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City | EAGAN
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State | MN
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Zip | 55121-1542
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Country | US
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Telephone | 626-272-5693
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Fax |
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Provider Business Mailing Address
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Address Line | 1477 W LAKE ST UNIT 408
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City | MINNEAPOLIS
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State | MN
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Zip | 55408-5117
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Country | US
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Telephone | 626-297-1432
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Fax |
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Authorized Official
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Title or Position | OPTOMETRIST
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Name | DR. VIGINIA HO
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Credential | OD
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Telephone | 626-297-1432
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 152W00000X
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Taxonomy Name | Optometrist
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License Number |
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License Number State |
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