Organization
PINECONE VISION CENTER, PA
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. NICHOLAS COLATRELLA O.D. (MEDICAL DIRECTOR)
(320) 258-3915
Entity
Organization
Contact information
Practice address
2180 TROOP DR, SARTELL, MN 56377-7504
(320) 258-3915
(320) 258-3917
Mailing address
2180 TROOP DR, SARTELL, MN 56377-4563
(320) 258-3915
(320) 258-3917
Taxonomy
Speciality
Code
Description
License number
State
152W00000X
Optometrist
Primary
2617
MN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1790830701
—
MN
Enumeration date
01/23/2007
Last updated
06/28/2022
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