Robert Bach Kennedy OD

NPI 1023000312 - Optometrist - 152W00000X

NPI Details
NPI 1023000312
Gender Male
Enumeration Date 08/22/2005
Last Updated 07/08/2007
Entity Type Individual
Active Over 11 years ago
Practice Location
1790 LEXINGTON AVE N
ROSEVILLE MN, 55113-6167, US
Phone (651) 488-6771
Fax (651) 488-5576
Business Location
1790 LEXINGTON AVE N
ROSEVILLE MN, 55113-6167, US
Phone (651) 488-6771
Fax (651) 488-5576
Toxanomy
Taxonomy Code 152W00000X
License State Minnesota
License Number LD1699000
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According to our database, Dr. Robert Bach Kennedy OD NPI is 1023000312, taxonomy code is 152W00000X and license number is LD1699000, license state is located at Minnesota. Robert Bach Kennedy OD physically located at 1790 Lexington Ave N, Roseville MN, 55113-6167. NPI Number Robert Bach Kennedy OD has the Individual type.

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1023000312 NPI number is provided on an as is basis without warranty of any kind. 1023000312 is maintained by the National Plan & Provider Enumeration System. The contents of Robert Bach Kennedy OD are for informational purposes only.