Individual
KAITLYN ANDERSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
8081 WEDGEWOOD LN N, MAPLE GROVE, MN 55369-9412
(763) 416-3795
Mailing address
2841 BRYANT AVE S APT 327, MINNEAPOLIS, MN 55408-4883
Taxonomy
Speciality
Code
Description
License number
State
152W00000X
Optometrist
Primary
3538
MN
Other
Enumeration date
10/27/2017
Last updated
10/27/2017
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