Organization
PBR OPTOMETRISTS LTD
Active
Organization subpart
No
Provider details
NPI number
Authorized official
ROGER D PABST O.D. (OWNER)
(507) 637-5715
Entity
Organization
Contact information
Practice address
500 E BRIDGE ST, REDWOOD FALLS, MN 56283-1168
(507) 637-5715
(507) 637-5715
Mailing address
PO BOX 479, REDWOOD FALLS, MN 56283-0479
(507) 637-5715
(507) 637-5715
Taxonomy
Speciality
Code
Description
License number
State
152W00000X
Optometrist
Primary
1616
MN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
47652PB
BLUECROSS BLUESHIELD
MN
01
—
990021013139
PREFERREDONE
MN
Enumeration date
01/25/2007
Last updated
04/04/2008
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