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General NPI Number Information
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NPI Number | 1780703645
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Entity Type | Organization
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Legal Business Name | CONROY EYE CARE, PA
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Dates
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Enumeration Date | 03/29/2007
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Last Update Date | 02/02/2017
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Provider Practice Location Address
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Address Line | 217 3RD ST NW
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City | ORTONVILLE
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State | MN
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Zip | 56278-1491
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Country | US
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Telephone | 320-839-2608
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Fax | 320-839-2601
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Provider Business Mailing Address
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Address Line | 217 3RD ST NW
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City | ORTONVILLE
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State | MN
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Zip | 56278-1491
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Country | US
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Telephone | 320-839-2608
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Fax | 320-839-2601
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Authorized Official
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Title or Position | PRESIDENT
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Name | DR. CHRISTOPHER JAMES CONROY
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Credential | OD
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Telephone | 320-839-2608
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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 | 2679
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License Number State | MN
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