Organization
BRUCE D NELSON
Active
Other names
Pelican River Optical
Organization subpart
No
Provider details
NPI number
Authorized official
MR. BRUCE DONALD NELSON (OPTICIAN/OWNER)
(218) 847-5663
Entity
Organization
Contact information
Practice address
1131 JACKSON AVE, DETROIT LAKES, MN 56501-3618
(218) 847-5663
(218) 847-0964
Mailing address
1131 JACKSON AVE, DETROIT LAKES, MN 56501-3618
(218) 847-5663
(218) 847-0964
Taxonomy
Speciality
Code
Description
License number
State
332H00000X
Eyewear Supplier
Primary
—
—
Other
Enumeration date
03/09/2008
Last updated
07/16/2008
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