Organization
BRUBAKER VISION LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
ELLIOTT DALE BRUBAKER O.D. (PRESIDENT)
(612) 240-3814
Entity
Organization
Contact information
Practice address
11712 GALTIER DR, BURNSVILLE, MN 55337-3208
(612) 240-3814
Mailing address
7835 150TH ST W, APPLE VALLEY, MN 55124-7181
(952) 431-9709
Taxonomy
Speciality
Code
Description
License number
State
152W00000X
Optometrist
Primary
2514
MN
Other
Enumeration date
08/05/2015
Last updated
08/05/2015
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