Individual
DR. GLENN ORVILLE KALLEVIG
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
O.D.
Contact information
Practice address
101 S RUM RIVER DR, PRINCETON, MN 55371-1815
(763) 389-9000
Mailing address
14940 47TH ST NE, FOLEY, MN 56329-4621
(320) 968-8091
Taxonomy
Speciality
Code
Description
License number
State
152W00000X
Optometrist
Primary
2359
MN
Other
Enumeration date
12/26/2006
Last updated
07/08/2007
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