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General NPI Number Information
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NPI Number | 1245349331
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Entity Type | Individual
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Provider Name | MELISSA MARIE HINDERSCHIED OD
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Gender | Female
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Dates
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Enumeration Date | 08/30/2006
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Last Update Date | 07/08/2007
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Provider Practice Location Address
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Address Line | 1948 1ST AVE NE
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City | LITTLE FALLS
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State | MN
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Zip | 56345
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Country | US
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Telephone | 320-632-9201
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Fax | 320-632-9202
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Provider Business Mailing Address
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Address Line | PO BOX 247 410 ASPEN CT
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City | ROCKVILLE
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State | MN
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Zip | 56369
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Country | US
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Telephone | 320-253-4868
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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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 | 2817
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License Number State | MN
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