Individual
ERIC JACK-MUN BOHJANEN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
O.D.
Contact information
Practice address
2106 LONDON RD, DULUTH, MN 55812-2127
(218) 522-4645
(218) 481-7811
Mailing address
2106 LONDON RD, DULUTH, MN 55812-2127
(218) 522-4645
(218) 481-7811
Taxonomy
Speciality
Code
Description
License number
State
152W00000X
Optometrist
Primary
3420
MN
156FX1800X
Optician
3420
MN
332H00000X
Eyewear Supplier
3420
MN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1477512697
—
MN
01
—
H400321094
INDIVIDUAL PTAN
MN
Enumeration date
03/17/2006
Last updated
07/21/2022
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