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General NPI Number Information
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NPI Number | 1760580922
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Entity Type | Individual
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Provider Name | CAROL MURIE
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Gender | Female
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Dates
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Enumeration Date | 09/20/2006
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Last Update Date | 07/08/2007
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Provider Practice Location Address
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Address Line | 2800 S COLUMBIA RD
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City | GRAND FORKS
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State | ND
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Zip | 58201-6076
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Country | US
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Telephone | 701-772-7767
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Fax |
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Provider Business Mailing Address
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Address Line | 2497 S 36TH ST
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City | GRAND FORKS
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State | ND
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Zip | 58201-5946
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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 |
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Name |
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Credential |
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Telephone |
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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 | 450
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License Number State | ND
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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 | 2098
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License Number State | MN
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