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General NPI Number Information
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NPI Number | 1821125535
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Entity Type | Organization
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Legal Business Name | STRUSS OPTICAL, INC.
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Dates
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Enumeration Date | 02/28/2007
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Last Update Date | 07/31/2008
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Provider Practice Location Address
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Address Line | 434 W 3RD ST
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City | RED WING
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State | MN
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Zip | 55066-2309
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Country | US
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Telephone | 651-388-6922
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Fax | 651-267-2411
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Provider Business Mailing Address
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Address Line | 434 W 3RD ST
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City | RED WING
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State | MN
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Zip | 55066-2309
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Country | US
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Telephone | 651-388-6922
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Fax | 651-267-2411
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Authorized Official
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Title or Position | OPTICIAN OWNER
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Name | DANIEL M. STRUSS
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Credential |
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Telephone | 651-388-6922
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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 | 2672
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License Number State | MN
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