Individual
SHAYNA MELLESMOEN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
OD
Contact information
Practice address
9117 LYNDALE AVE S, BLOOMINGTON, MN 55420-3522
(952) 835-1235
Mailing address
8115 2ND AVE S, BLOOMINGTON, MN 55420-1211
(952) 686-4553
Taxonomy
Speciality
Code
Description
License number
State
152W00000X
Optometrist
Primary
3883
MN
Other
Enumeration date
06/29/2023
Last updated
06/29/2023
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