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Individual

DR. RICHARD A PERROTT

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man
Credential
O.D.

Contact information

Practice address
15 NE 5TH ST, GRAND RAPIDS, MN 55744-2601
(218) 327-1148
(218) 327-0386
Mailing address
15 NE 5TH ST, GRAND RAPIDS, MN 55744-2601
(218) 327-1148
(218) 327-0386

Taxonomy

Speciality
Code
Description
License number
State
152W00000X
Optometrist
Primary
1638
MN

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
22-00208
MEDICA
MN
01
70514PE
BLUE CROSS BLUE SHIELD
MN
01
983831011287
PREFERRED ONE
MN
Enumeration date
10/20/2006
Last updated
07/08/2007
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