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Individual

KAYLA MILLER BECHTHOLD

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
OD

Contact information

Practice address
11 1ST AVE NW, CHISHOLM, MN 55719
(218) 254-4393
(218) 786-9375
Mailing address
11 1ST AVE NW, CHISHOLM, MN 55719-1811
(218) 254-4393
(218) 786-9375

Taxonomy

Speciality
Code
Description
License number
State
152W00000X
Optometrist
Primary
2696
MN

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
714754600
MN
Enumeration date
06/27/2006
Last updated
09/19/2019
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