Individual
LYNN ALAN SULERUD
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
O.D.
Contact information
Practice address
12170 ABERDEEN ST NE, BLAINE, MN 55449-4716
(763) 757-7000
(763) 757-3328
Mailing address
12170 ABERDEEN ST NE, BLAINE, MN 55449-4716
(763) 757-7000
(763) 757-3328
Taxonomy
Speciality
Code
Description
License number
State
152W00000X
Optometrist
Primary
1698
MN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
844523100
—
MN
Enumeration date
01/19/2007
Last updated
09/27/2010
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