Organization
COREY H TABBERT OD PA
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. COREY TABBERT OD (OWNER)
(218) 327-1148
Entity
Organization
Contact information
Practice address
15 NE 5TH ST, GRAND RAPIDS, MN 55744-2760
(218) 327-1148
Mailing address
15 NE 5TH ST, GRAND RAPIDS, MN 55744-2760
(218) 327-1148
Taxonomy
Speciality
Code
Description
License number
State
152W00000X
Optometrist
Primary
2883
MN
Other
Enumeration date
03/12/2012
Last updated
08/30/2012
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