Individual
PAUL A. HENRIKSEN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
O.D.
Contact information
Practice address
212 W. MAIN ST., PIPESTONE, MN 56164-1634
(507) 825-5444
Mailing address
PO BOX 686, PIPESTONE, MN 56164-0686
(507) 825-5444
(507) 825-5286
Taxonomy
Speciality
Code
Description
License number
State
152W00000X
Optometrist
Primary
1922
MN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
896523400
—
MN
Enumeration date
08/25/2005
Last updated
01/22/2020
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