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NPI Code Detail

MEDICARE: DANIEL WILLIAM SOLBRACK O.D.

MEDICARE:   DANIEL WILLIAM SOLBRACK  O.D.
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
1152W00000XOptometrist2273MN

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number : 1992828602
Entity Type Code : Individual
Provider Name (Legal Business Name) : DANIEL WILLIAM SOLBRACK O.D.
Provider Business Mailing Address
First Line : 32079 JACKSON CT NE
Second Line :
City : CAMBRIDGE
State : MN
Zip : 55008-6878
Country : US
Telephone Number : 763-689-5853
Fax Number :
Provider Business Practice Location Address
First Line : 523 1ST ST
Second Line :
City : PRINCETON
State : MN
Zip : 55371-1603
Country : US
Telephone Number : 763-389-3150
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 04/09/2007
Last Update Date : 05/02/2012

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Directions to “ DANIEL WILLIAM SOLBRACK O.D.” Practice Location

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