Individual
SCOTT M PASTRYK
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
OD
Contact information
Practice address
855 MANKATO AVE, WINONA, MN 55987-4868
(507) 454-3650
Mailing address
855 MANKATO AVE, WINONA, MN 55987-4868
(507) 454-3650
Taxonomy
Speciality
Code
Description
License number
State
152W00000X
Optometrist
18003284A
IN
152W00000X
Optometrist
Primary
3115
MN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
18003284A
OPTOMETRIST LICENSE
IN
05
—
200498370
—
IN
Enumeration date
12/23/2005
Last updated
12/21/2011
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