Individual
AI SOUNDARA
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
O.D.
Contact information
Practice address
3745 LOUISIANA AVE S, ST LOUIS PARK, MN 55426-4361
(952) 926-1775
(952) 926-3845
Mailing address
3745 LOUISIANA AVE S, ST LOUIS PARK, MN 55426-4361
(952) 926-1775
(952) 926-3845
Taxonomy
Speciality
Code
Description
License number
State
152W00000X
Optometrist
Primary
3253
MN
152WC0802X
Corneal and Contact Management Optometrist
3253
MN
Other
Enumeration date
08/12/2011
Last updated
08/12/2011
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