Organization
AGASSIZ OPTOMETRY ASSOCIATES PC
Active
Other names
Crookston Eye Clinic
Organization subpart
No
Provider details
NPI number
Authorized official
DR. MATTHEW C FORGIT O.D. (OPTOMETRIST)
(218) 281-2020
Entity
Organization
Contact information
Practice address
216 S MAIN ST, CROOKSTON, MN 56716-1939
(218) 281-2020
Mailing address
216 S MAIN ST, CROOKSTON, MN 56716-1939
(218) 281-2020
(218) 281-5997
Taxonomy
Speciality
Code
Description
License number
State
152W00000X
Optometrist
Primary
2964
MN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
6691490001
DMERC
MN
Enumeration date
11/09/2011
Last updated
04/23/2014
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