Individual
MARILYN MARIE KOBERNUSZ
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
43318 SD HIGHWAY 38, SPENCER, SD 57374-5403
(605) 421-1818
Mailing address
43318 SD HIGHWAY 38, SPENCER, SD 57374-5403
(605) 421-1818
Taxonomy
Speciality
Code
Description
License number
State
156FX1800X
Optician
—
—
332H00000X
Eyewear Supplier
Primary
—
—
Other
Enumeration date
06/23/2021
Last updated
07/20/2021
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