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Individual

SHANON S BENCKER

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
OD

Contact information

Practice address
738 KIRKWOOD MALL, MIDWEST VISION CENTERS, BISMARCK, ND 58504
(701) 258-8810
(701) 258-8811
Mailing address
738 KIRKWOOD MALL, BISMARCK, ND 58504
(701) 258-8810
(701) 258-8811

Taxonomy

Speciality
Code
Description
License number
State
152W00000X
Optometrist
Primary
551
ND

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
60523
ND
Enumeration date
08/30/2006
Last updated
07/08/2007
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