Organization
20-20 OPTICAL INC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. DAVID G. GAUSTAD (OWNER/MANAGER)
(218) 998-2020
Entity
Organization
Contact information
Practice address
615 S MILL ST, STE 2, FERGUS FALLS, MN 56537-2756
(218) 998-2020
(218) 998-2098
Mailing address
615 S MILL ST, STE 2, FERGUS FALLS, MN 56537-2756
(218) 998-2020
(218) 998-2098
Taxonomy
Speciality
Code
Description
License number
State
156FX1800X
Optician
—
MN
332H00000X
Eyewear Supplier
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
031024003
—
MN
01
—
1046788
PREFERRED ONE
—
05
—
21-00143
—
TX
01
—
4C789TW
BLUE CROSS BLUE SHIELD MN
MN
05
—
55387
—
ND
01
—
892886
ND VISION SERVICES
ND
05
—
985222100
—
MN
01
—
VMN000233
AVESIS
AZ
Enumeration date
06/15/2005
Last updated
07/13/2009
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