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General NPI Number Information
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NPI Number | 1427170505
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Entity Type | Organization
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Legal Business Name | OPTICAL ASSOCIATES INC
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Dates
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Enumeration Date | 04/06/2007
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Last Update Date | 06/05/2008
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Provider Practice Location Address
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Address Line | 1523 METRO DR
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City | SCHOFIELD
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State | WI
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Zip | 54476-2378
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Country | US
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Telephone | 715-355-8800
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Fax |
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Provider Business Mailing Address
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Address Line | 15780 SKYLINE AVE NW
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City | PRIOR LAKE
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State | MN
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Zip | 55372-1629
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position | OWNER
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Name | MR. MERLIN STRAND JR.
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Credential |
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Telephone | 763-784-4081
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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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Taxonomy #2
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Taxonomy Code | 156FX1800X
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Taxonomy Name | Optician
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License Number |
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License Number State |
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