Individual
DR. BRUCE A. STORHAUG
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
O.D.
Contact information
Practice address
421 DEMERS AVE. NW, EAST GRAND FORKS, MN 56721-1835
(218) 773-3438
(218) 773-1645
Mailing address
306 CIRCLE HILLS DR, GRAND FORKS, ND 58201-7750
(701) 780-9654
Taxonomy
Speciality
Code
Description
License number
State
152W00000X
Optometrist
Primary
2162
MN
152W00000X
Optometrist
452
ND
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
349023800
—
MN
05
—
60458
—
ND
Enumeration date
06/28/2006
Last updated
07/08/2007
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