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General NPI Number Information
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NPI Number | 1972922078
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Entity Type | Organization
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Legal Business Name | ASHBY OPTOMETRY PC
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Dates
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Enumeration Date | 04/16/2014
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Last Update Date | 12/15/2020
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Provider Practice Location Address
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Address Line | 1447 EAST 7TH STREET
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City | MONTICELLO
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State | MN
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Zip | 55362
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Country | US
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Telephone | 320-250-6254
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Fax | 888-785-9518
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Provider Business Mailing Address
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Address Line | 2416 MEADOW DR
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City | BUFFALO
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State | MN
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Zip | 55313-2424
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Country | US
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Telephone | 320-250-6254
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Fax | 888-785-9518
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Authorized Official
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Title or Position | PRESIDENT / CEO
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Name | DR. ERIC SCOTT BAILEY
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Credential | O.D.
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Telephone | 320-250-6254
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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 | 2232
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License Number State | MN
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