MEDICARE: MR. NEIL SCHLONER ABOC

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	156FX1800X	Optician		MN

General Provider Information

NPI Number	:	1801969993
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MR. NEIL SCHLONER ABOC

Provider Business Mailing Address
First Line	:	3543 DOUGLAS DR N
Second Line	:
City	:	CRYSTAL
State	:	MN
Zip	:	55422-2415
Country	:	US
Telephone Number	:	763-533-4084
Fax Number	:	763-533-1442

Provider Business Practice Location Address
First Line	:	3543 DOUGLAS DR N
Second Line	:
City	:	CRYSTAL
State	:	MN
Zip	:	55422-2415
Country	:	US
Telephone Number	:	763-533-4084
Fax Number	:	763-533-1442

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	11/16/2006
Last Update Date	:	07/08/2007

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