Organization
SHOPTIKAL LLC
Active
Other names
Shopko Optical 4302
Organization subpart
No
Provider details
NPI number
Authorized official
RUSSELL STEINHORST (EVP & CFO)
(920) 429-7489
Entity
Organization
Contact information
Practice address
105 SW 23RD ST STE B, GRAND RAPIDS, MN 55744
(218) 326-1775
Mailing address
PO BOX 19060, GREEN BAY, WI 54307-9060
Taxonomy
Speciality
Code
Description
License number
State
152W00000X
Optometrist
—
—
332H00000X
Eyewear Supplier
Primary
—
—
Other
Enumeration date
01/10/2024
Last updated
11/29/2024
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