Organization
GARY L. RENIER, O.D. LTD
Active
Organization subpart
No
Provider details
NPI number
Authorized official
GARY L. RENIER O.D. (PRESIDENT)
(701) 239-9711
Entity
Organization
Contact information
Practice address
101 10TH ST N, STE 120, FARGO, ND 58102-4600
(701) 239-9771
(701) 293-0944
Mailing address
101 10TH ST N, STE 120, FARGO, ND 58102-4600
(701) 239-9771
(701) 293-0944
Taxonomy
Speciality
Code
Description
License number
State
152W00000X
Optometrist
Primary
339
ND
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
11351
BLUE CROSS OF ND
ND
01
—
2227152
MEDICA
ND
01
—
2C934RE
BLUE CROSS OF MN
MN
05
—
402225400
—
MN
05
—
60443
—
ND
01
—
824258102
TRICARE
ND
01
—
REN800339
ND VISION
ND
Enumeration date
04/16/2008
Last updated
10/30/2008
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