Individual
BRADLEY LYN CALLIES
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
OD
Contact information
Practice address
127 W VINE ST, OWATONNA, MN 55060-2320
(507) 451-5300
Mailing address
17 7TH ST NW, BYRON, MN 55920-1470
(605) 352-1904
Taxonomy
Speciality
Code
Description
License number
State
152W00000X
Optometrist
Primary
3308
MN
152W00000X
Optometrist
589
SD
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
9201292
—
SD
Enumeration date
07/20/2006
Last updated
07/21/2022
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