Individual
MR. JOHN PETER VORDERBRUGGEN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
OPTICIAN
Contact information
Practice address
901 N 23RD AVE W, DULUTH, MN 55806-1244
(218) 726-0078
Mailing address
901 N 23RD AVE W, DULUTH, MN 55806-1244
(218) 726-0078
Taxonomy
Speciality
Code
Description
License number
State
156FX1800X
Optician
Primary
2729202
MN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
2100074
ALLINA MEDICA
MN
Enumeration date
03/07/2008
Last updated
03/07/2008
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