Organization
MADELIA OPTOMETRIC, INC.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. VIKTORIA L DAVIS O.D. (PRESIDENT)
(507) 642-3853
Entity
Organization
Contact information
Practice address
18 BENZEL AVE NW, MADELIA, MN 56062-1422
(507) 642-3853
(507) 642-3854
Mailing address
PO BOX 190, MADELIA, MN 56062-0190
(507) 642-3853
(507) 642-3854
Taxonomy
Speciality
Code
Description
License number
State
152W00000X
Optometrist
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
120152200
—
MN
01
—
262M6MA
BLUE CROSS BLUE SHIELD OF MN
MN
Enumeration date
04/17/2008
Last updated
01/16/2025
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