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Individual

GERMAINE E CHESLOCK

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
O.D.

Contact information

Practice address
1611 ANNE ST NW, BEMIDJI, MN 56601-5114
(218) 333-2020
(218) 333-2019
Mailing address
PO BOX 5074, SIOUX FALLS, SD 57117-5074

Taxonomy

Speciality
Code
Description
License number
State
152W00000X
Optometrist
Primary
2300
MN
152WC0802X
Corneal and Contact Management Optometrist
2300
MN

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
1011212
PREFERREDONE
01
2204340
MEDICA
01
28642
ND BCBS
ND
05
571725600
MN
01
942G7CH
MN BCBS
MN
01
HP57666
HEALTHPARTNERS
Enumeration date
01/31/2007
Last updated
02/01/2023
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