Organization
STANTON L ANDRIST & CASEY C BARTZ
Active
Other names
Moorhead Vision Associates
Organization subpart
No
Provider details
NPI number
Authorized official
STANTON L ANDRIST OD (OWNTER/OD)
(218) 233-1624
Entity
Organization
Contact information
Practice address
420 CENTER AVE, SUITE 41, MOORHEAD, MN 56560-1957
(218) 233-1624
(218) 233-2058
Mailing address
420 CENTER AVE, SUITE 41, MOORHEAD, MN 56560-1957
(218) 233-1624
(218) 233-2058
Taxonomy
Speciality
Code
Description
License number
State
152W00000X
Optometrist
1532
MN
152W00000X
Optometrist
Primary
2021
MN
152W00000X
Optometrist
3196
MN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
6682310001
DMERC SUPPLIER NUMBER
MN
Enumeration date
01/27/2012
Last updated
03/18/2014
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