Organization
EYE CARE ASSOCIATES OF FARIBAULT
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. DAVID E MALMANGER O.D. (OPTOMETRIST/OWNER)
(507) 334-0011
Entity
Organization
Contact information
Practice address
112 4TH ST NW, FARIBAULT, MN 55021-5101
(507) 334-0011
(507) 331-0012
Mailing address
PO BOX 575, FARIBAULT, MN 55021-0575
(507) 334-0011
(507) 331-0012
Taxonomy
Speciality
Code
Description
License number
State
261Q00000X
Clinic/Center
Primary
2204
MN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
099223200
—
MN
Enumeration date
04/07/2009
Last updated
04/07/2009
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