Organization
SHOPTIKAL LLC
Active
Other names
Shopko Optical 4251
Organization subpart
No
Provider details
NPI number
Authorized official
RUSSELL STEINHORST (EVP & CFO)
(920) 429-7489
Entity
Organization
Contact information
Practice address
1267 W BROADWAY AVE STE 300, FOREST LAKE, MN 55025-1418
(920) 429-2211
Mailing address
PO BOX 19060, GREEN BAY, WI 54307-9060
(920) 429-7842
Taxonomy
Speciality
Code
Description
License number
State
152W00000X
Optometrist
—
—
332H00000X
Eyewear Supplier
Primary
—
—
Other
Enumeration date
06/13/2021
Last updated
11/29/2024
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