Individual
JOY M QUITBERG
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
OD
Contact information
Practice address
1245 WASHINGTON AVE, DETROIT LAKES, MN 56501-3905
(218) 846-2000
Mailing address
PO BOX 5074, SIOUX FALLS, SD 57117-5074
Taxonomy
Speciality
Code
Description
License number
State
152W00000X
Optometrist
2897
MN
152W00000X
Optometrist
Primary
645
ND
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
903130800
—
MN
Enumeration date
07/04/2006
Last updated
02/08/2022
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