Individual
DR. CHAD M. KRIETLOW
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
O.D.
Contact information
Practice address
260 NORTHTOWN DR NE, BLAINE, MN 55434-1037
(763) 784-9049
(763) 717-6939
Mailing address
260 NORTHTOWN DR NE, BLAINE, MN 55434-1037
(763) 784-9049
(763) 717-6939
Taxonomy
Speciality
Code
Description
License number
State
152W00000X
Optometrist
Primary
MN2821
MN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
916244500
—
MN
Enumeration date
08/19/2006
Last updated
06/21/2010
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