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General NPI Number Information
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NPI Number | 1245384668
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Entity Type | Organization
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Legal Business Name | HATAYE-SOFTING OPTOMETRISTS, LTD.
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Dates
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Enumeration Date | 01/23/2007
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Last Update Date | 12/28/2011
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Provider Practice Location Address
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Address Line | 318 N MAIN ST
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City | AUSTIN
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State | MN
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Zip | 55912-3406
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Country | US
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Telephone | 507-437-7768
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Fax | 507-437-7769
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Provider Business Mailing Address
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Address Line | 318 N MAIN ST
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City | AUSTIN
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State | MN
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Zip | 55912-3406
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Country | US
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Telephone | 507-437-7768
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Fax | 507-437-7769
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Authorized Official
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Title or Position | PRESIDENT
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Name | DR. GARETH HATAYE
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Credential | O.D.
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Telephone | 507-437-7768
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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 | 2212
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License Number State | MN
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Taxonomy #2
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Taxonomy Code | 152W00000X
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Taxonomy Name | Optometrist
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License Number | 2189
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License Number State | MN
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