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Organization
PRODIGY OPTICAL, INC
Active
Organization
PRODIGY OPTICAL, INC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MRS. DIANE WOJTANOWICZ (OWNER)
(320) 597-5252
Entity
Organization
Contact information
Practice address
314 IVY AVE SE, RICHMOND, MN 56368-4509
(320) 597-5252
(320) 597-5250
Mailing address
314 IVY AVE SE, PO BOX 680, RICHMOND, MN 56368-4509
(320) 597-5252
(320) 597-5250
Taxonomy
Speciality
Code
Description
License number
State
332H00000X
Eyewear Supplier
Primary
—
—
Other
Enumeration date
10/11/2007
Last updated
10/11/2007
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