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General NPI Number Information
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NPI Number | 1497817928
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Entity Type | Organization
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Legal Business Name | LYNETTE ROSE CATAPANO OD PC
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Dates
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Enumeration Date | 12/14/2006
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Last Update Date | 01/17/2013
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Provider Practice Location Address
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Address Line | 814 CLEARWATER CTR
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City | CLEARWATER
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State | MN
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Zip | 55320
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Country | US
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Telephone | 320-558-9403
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Fax | 320-558-4583
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Provider Business Mailing Address
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Address Line | PO BOX 275
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City | CLEARWATER
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State | MN
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Zip | 55320-0275
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Country | US
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Telephone | 320-558-9403
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Fax | 320-558-4583
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Authorized Official
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Title or Position | OWNER
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Name | LYNETTE ROSE CATAPANO
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Credential | OD, PC
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Telephone | 320-558-9403
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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 | 2281
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License Number State | MN
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