Organization
BONACCI OPTOMETRY INC., P.C.
Active
Other names
Derek Bonacci
Organization subpart
No
Provider details
NPI number
Authorized official
DR. DEREK JOHN BONACCI O.D. (OPTOMETRY)
(407) 415-7551
Entity
Organization
Contact information
Practice address
4611 HIGHWAY 29 S, ALEXANDRIA, MN 56308-6175
(320) 762-4044
(320) 762-4046
Mailing address
11 GLENVIEW LOOP, SAINT CLOUD, MN 56303-4865
(407) 415-7551
(320) 762-4046
Taxonomy
Speciality
Code
Description
License number
State
152W00000X
Optometrist
Primary
3170
MN
Other
Enumeration date
10/31/2011
Last updated
10/31/2011
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