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General NPI Number Information
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NPI Number | 1326235912
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Entity Type | Organization
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Legal Business Name | ASSOCIATE OPTOMETRY, P.A.
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Dates
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Enumeration Date | 09/27/2007
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Last Update Date | 09/27/2007
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Provider Practice Location Address
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Address Line | 111 E 6TH ST
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City | BLUE EARTH
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State | MN
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Zip | 56013-2003
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Country | US
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Telephone | 507-526-2020
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Fax | 507-526-4421
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Provider Business Mailing Address
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Address Line | PO BOX 309
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City | BLUE EARTH
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State | MN
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Zip | 56013-0309
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Country | US
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Telephone | 507-526-2020
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Fax | 507-526-4421
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Authorized Official
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Title or Position | OPTOMETRIST
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Name | DR. JAMES BUSCHE
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Credential | O.D.
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Telephone | 507-526-2020
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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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