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Organization
L.M. AFFOLTER O.D.
Active
Organization
L.M. AFFOLTER O.D.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. LEROY M AFFOLTER O.DO (OWNER)
(507) 532-5143
Entity
Organization
Contact information
Practice address
121 N 3RD ST, MARSHALL, MN 56258-1324
(507) 532-5143
(507) 532-5143
Mailing address
121 N 3RD ST, MARSHALL, MN 56258-1324
(507) 532-5143
(507) 532-5143
Taxonomy
Speciality
Code
Description
License number
State
332H00000X
Eyewear Supplier
Primary
1370
MN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
11257
UCARE
MN
05
—
2282361
—
MN
01
—
46009AF
BCBS
MN
01
—
5C002AF
BCBS
MN
01
—
930531027150
PREFERRED
MN
Enumeration date
03/17/2008
Last updated
03/17/2008
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