Organization
S SJOBERG PLC
Active
Parent organization
S SJOBERG PCL
Organization subpart
Yes
Provider details
NPI number
Legal business name
S SJOBERG PCL
Authorized official
DR. STACY ANN SJOBERG MD PHD (SOLE PROPRIETOR)
(218) 546-5108
Entity
Organization
Contact information
Practice address
7636 DESIGN RD, SUITE 105, BAXTER, MN 56425-8677
(218) 825-1976
(218) 828-9869
Mailing address
1 3RD AVE NE, CROSBY, MN 56441-1665
(218) 546-5108
(218) 546-5736
Taxonomy
Speciality
Code
Description
License number
State
152W00000X
Optometrist
—
—
152WC0802X
Corneal and Contact Management Optometrist
—
—
152WL0500X
Low Vision Rehabilitation Optometrist
—
—
152WP0200X
Pediatric Optometrist
—
—
152WS0006X
Sports Vision Optometrist
—
—
152WV0400X
Vision Therapy Optometrist
—
—
152WX0102X
Occupational Vision Optometrist
—
—
207W00000X
Ophthalmology Physician
Primary
—
—
Other
Enumeration date
07/28/2014
Last updated
03/16/2015
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