Organization
OPTICAL OUTLOOK, P.C.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. BRUCE ALLEN MOEN O.D. (PRESIDENT)
(701) 837-0022
Entity
Organization
Contact information
Practice address
1100 31ST AVE SW, SUITE 2, MINOT, ND 58701-2007
(701) 837-0022
(701) 839-2005
Mailing address
1100 31ST AVE SW, SUITE 2, MINOT, ND 58701-2007
(701) 837-0022
(701) 839-2005
Taxonomy
Speciality
Code
Description
License number
State
152W00000X
Optometrist
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
22882
BCBS OF ND
ND
05
—
60582
—
ND
Enumeration date
06/18/2006
Last updated
10/05/2007
Update your record
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