Individual
STACY PIRRUCCELLO
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
OD
Contact information
Practice address
13195 WEAVER LAKE RD, MAPLE GROVE, MN 55369-9410
(763) 420-5112
Mailing address
2701 ISLEVIEW RD, GRAND RAPIDS, MN 55744-9769
(218) 259-5782
Taxonomy
Speciality
Code
Description
License number
State
152W00000X
Optometrist
Primary
3587
MN
Other
Enumeration date
07/24/2018
Last updated
11/16/2022
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