Individual
DR. MICHAEL JOHN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
O.D.
Contact information
Practice address
1639 ANDERSON AVE., BOCK, MN 56313
(320) 556-3521
Mailing address
PO BOX 66, MILACA, MN 56353-0066
(320) 556-3521
Taxonomy
Speciality
Code
Description
License number
State
152W00000X
Optometrist
Primary
2357
MN
Other
Enumeration date
10/20/2016
Last updated
10/20/2016
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