Individual
STACI LYNN COLLISON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
506 BELTRAMI AVE NW, BEMIDJI, MN 56601
(218) 751-2020
Mailing address
PO BOX 5074, SIOUX FALLS, SD 57117-5074
(605) 328-6585
Taxonomy
Speciality
Code
Description
License number
State
152W00000X
Optometrist
Primary
3378
MN
390200000X
Student in an Organized Health Care Education/Training Program
—
—
Other
Enumeration date
10/19/2011
Last updated
03/22/2023
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