Individual
DR. JESSICA CHIYOKO FEDOR
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
O.D.
Contact information
Practice address
9055 SPRINGBROOK DR NW, COON RAPIDS, MN 55433
(763) 780-9155
(763) 236-1066
Mailing address
2925 CHICAGO AVE, MINNEAPOLIS, MN 55407-1321
(612) 262-5000
Taxonomy
Speciality
Code
Description
License number
State
152W00000X
Optometrist
Primary
3028
MN
Other
Enumeration date
10/03/2006
Last updated
08/27/2019
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