Organization
PINE EYE ASSOCIATES, PA
Active
Other names
Pine Eye Associates
Organization subpart
No
Provider details
NPI number
Authorized official
KRISTI A IVERSON OD (CFO, OWNER)
(320) 629-7262
Entity
Organization
Contact information
Practice address
110 EVERGREEN SQUARE, PINE CITY, MN 55063
(320) 629-7262
(320) 629-7789
Mailing address
110 EVERGREEN SQUARE, PINE CITY, MN 55063
(320) 629-7262
(320) 629-7789
Taxonomy
Speciality
Code
Description
License number
State
152W00000X
Optometrist
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
644731700
—
MN
Enumeration date
07/08/2006
Last updated
03/12/2009
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