Individual
DR. PENNY P VIZINA
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
OD
Contact information
Practice address
2560 HARVEST LN, OWATONNA, MN 55060-4305
(507) 451-3072
(507) 451-4291
Mailing address
2560 HARVEST LN, OWATONNA, MN 55060-4305
(507) 451-3072
(507) 451-4291
Taxonomy
Speciality
Code
Description
License number
State
152W00000X
Optometrist
Primary
2381
MN
152W00000X
Optometrist
4901003736
MI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
3108975
—
MI
01
—
900A760100
BLUE CROSS AND BLUE SHIELD
—
Enumeration date
10/04/2006
Last updated
05/28/2019
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