Individual
RONN E MCDANIEL
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
OD
Contact information
Practice address
128 2ND ST NW, ORTONVILLE, MN 56278-1409
(320) 839-3413
Mailing address
100 LAKE TRAVERSE DR, SISSETON, SD 57262-7046
(605) 742-3620
(605) 742-3881
Taxonomy
Speciality
Code
Description
License number
State
152W00000X
Optometrist
Primary
2619
MN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
5C857MC
BLUE CROSS BLUE SHIELD
MN
05
—
848152100
—
MN
Enumeration date
01/17/2007
Last updated
02/01/2017
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