Organization
AVERA MARSHALL
Active
Other names
Avera Medical Group Optometry Mountain Lake
Organization subpart
No
Provider details
NPI number
Authorized official
DEBBIE STREIER (CEO)
(507) 537-9160
Entity
Organization
Contact information
Practice address
1040 3RD AVE, MOUNTAIN LAKE, MN 56159-1587
(507) 427-2345
Mailing address
1040 3RD AVE, MOUNTAIN LAKE, MN 56159-1587
(507) 427-2345
Taxonomy
Speciality
Code
Description
License number
State
152W00000X
Optometrist
Primary
—
MN
207W00000X
Ophthalmology Physician
—
—
332B00000X
Durable Medical Equipment & Medical Supplies
—
—
Other
Enumeration date
07/01/2010
Last updated
12/02/2022
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