Organization
RICHARD N KITTELSON
Active
Other names
OPTICAL EYEDEAS
Organization subpart
No
Provider details
NPI number
Authorized official
MR. RICHARD N KITTELSON ABOC (OPTICIAN/OWNER)
(218) 847-8021
Entity
Organization
Contact information
Practice address
918 WASHINGTON AVE, DETROIT LAKES, MN 56501-3402
(218) 847-8021
(218) 846-9552
Mailing address
918 WASHINGTON AVE, DETROIT LAKES, MN 56501-3402
(218) 847-8021
(218) 846-9552
Taxonomy
Speciality
Code
Description
License number
State
156FX1800X
Optician
Primary
03590
MN
332H00000X
Eyewear Supplier
—
MN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1C991OP
BLUE CROSS BLUE SHIELD
MN
01
—
2100679
MEDICA
MN
01
—
OPT301766
NORTH DAKOTA VISION SERVI
ND
Enumeration date
09/09/2005
Last updated
09/11/2025
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