Individual
MR. RICKY FRANCIS GROETSCH
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
OD
Contact information
Practice address
203 E MAIN ST STE B, MELROSE, MN 56352-1485
(320) 256-4000
(320) 256-4002
Mailing address
203 E MAIN ST STE B, MELROSE, MN 56352-1485
(320) 256-4000
(320) 256-4002
Taxonomy
Speciality
Code
Description
License number
State
152W00000X
Optometrist
Primary
MN 2082
MN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0F373GR
BLUE CROSS PROVIDER NUMBE
MN
01
—
1006663
PREFERRED ONE PROVIDER NU
MN
01
—
115186
UCARE PROVIDER NUMBER
MN
01
—
2225597
MEDICA PROVIDER NUMBER
MN
05
—
380225600
—
MN
01
—
410031767
RAILROAD MEDICARE PROVIDE
MN
01
—
47576
HEALTH PARTNERS PROVIDER
MN
01
—
MN2082
EYEMED PROVIDER NUMBER
MN
Enumeration date
07/28/2006
Last updated
04/15/2010
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