Organization
GRANITE CITY FAMILY EYE CARE PA
Active
Organization subpart
No
Provider details
NPI number
Authorized official
REBECCA J HOFER OD (OWNER/OPTOMETRIST)
(320) 251-8061
Entity
Organization
Contact information
Practice address
414 GREAT OAK DR, WAITE PARK, MN 56387-2504
(320) 251-8061
(320) 202-8031
Mailing address
414 GREAT OAK DR, WAITE PARK, MN 56387-2504
(320) 251-8061
(320) 202-8031
Taxonomy
Speciality
Code
Description
License number
State
152W00000X
Optometrist
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1710903562
NPI
—
05
—
410002837
—
MN
01
—
V07233
UPIN
—
Enumeration date
06/13/2007
Last updated
03/07/2023
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