Individual
LAUREN MICHELE SOUKUP
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
OD
Contact information
Practice address
2500 COMO AVE, SAINT PAUL, MN 55108-1460
(651) 641-6200
Mailing address
8170 33RD AVE S # MS 21110Q, MINNEAPOLIS, MN 55425-4516
(651) 641-6200
Taxonomy
Speciality
Code
Description
License number
State
152W00000X
Optometrist
Primary
3516
MN
Other
Enumeration date
06/19/2017
Last updated
09/19/2019
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