Individual
DR. DOUGLAS ROLAND LANDSVERK
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
OD
Contact information
Practice address
312 MINNESOTA AVE N, AITKIN, MN 56431-1414
(218) 927-3213
(218) 927-2266
Mailing address
312 MINNESOTA AVE N, AITKIN, MN 56431-1414
(218) 927-3213
(218) 927-2266
Taxonomy
Speciality
Code
Description
License number
State
152W00000X
Optometrist
Primary
1998
MN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
097723300
—
MN
01
—
2210683
MEDICA
MN
01
—
5C924LA
BCBS
MN
Enumeration date
05/12/2006
Last updated
03/03/2009
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