Individual
MARK A KAPPHAHN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
OD
Contact information
Practice address
401 PHALEN BLVD, SAINT PAUL, MN 55130-5302
(651) 254-7500
Mailing address
8170 33RD AVE S # MS 21110Q, MINNEAPOLIS, MN 55425-4516
Taxonomy
Speciality
Code
Description
License number
State
152W00000X
Optometrist
Primary
2866
MN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
144842100
—
MN
Enumeration date
02/03/2006
Last updated
10/17/2022
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