Organization
SPECNIQUE BY STEPHANIE THIER OD PC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
STEPHANIE THIER OD (OPTOMETRIST)
(507) 360-0298
Entity
Organization
Contact information
Practice address
1607 MCMILLAN ST, WORTHINGTON, MN 56187-2802
(507) 727-3937
(507) 727-3939
Mailing address
1607 MCMILLAN ST, WORTHINGTON, MN 56187-2802
(507) 727-3937
(507) 727-3939
Taxonomy
Speciality
Code
Description
License number
State
152W00000X
Optometrist
Primary
594
SD
152W00000X
Optometrist
595
SD
152W00000X
Optometrist
601
SD
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
9203300
—
SD
05
—
9203302
—
SD
05
—
9203360
—
SD
05
—
9203362
—
SD
05
—
9203380
—
SD
05
—
9203382
—
SD
Enumeration date
09/26/2006
Last updated
05/14/2015
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