Organization
S SJOBERG PLC
Active
Other names
Great River Eye Clinic
Organization subpart
No
Provider details
NPI number
Authorized official
DR. STACY ANN SJOBERG M.D., PH.D (OWNER)
(218) 546-5108
Entity
Organization
Contact information
Practice address
1 3RD AVE NE, CROSBY, MN 56441-1665
(218) 546-5108
(218) 546-5736
Mailing address
1 3RD AVE NE, CROSBY, MN 56441-1665
(218) 546-5108
(218) 546-5736
Taxonomy
Speciality
Code
Description
License number
State
152W00000X
Optometrist
—
—
152WC0802X
Corneal and Contact Management Optometrist
—
—
152WL0500X
Low Vision Rehabilitation Optometrist
—
—
152WP0200X
Pediatric Optometrist
—
—
152WS0006X
Sports Vision Optometrist
—
—
152WV0400X
Vision Therapy Optometrist
—
—
152WX0102X
Occupational Vision Optometrist
—
—
261QH0100X
Health Service Clinic/Center
Primary
—
MN
Other
Enumeration date
07/11/2014
Last updated
08/23/2021
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