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General NPI Number Information
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NPI Number | 1437332939
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Entity Type | Organization
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Legal Business Name | DJ-MN, INC
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Dates
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Enumeration Date | 12/07/2007
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Last Update Date | 06/09/2014
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Provider Practice Location Address
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Address Line | 1700 HIGHWAY 25 N
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City | BUFFALO
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State | MN
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Zip | 55313-1930
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Country | US
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Telephone | 763-684-0025
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Fax | 763-684-0847
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Provider Business Mailing Address
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Address Line | 1700 HIGHWAY 25 N
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City | BUFFALO
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State | MN
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Zip | 55313-1930
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Country | US
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Telephone | 763-684-0025
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Fax | 763-684-0847
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Authorized Official
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Title or Position | OWNER
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Name | MRS. JANE M THELEN
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Credential |
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Telephone | 763-427-4000
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 332H00000X
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Taxonomy Name | Eyewear Supplier
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License Number |
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License Number State |
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