Xuanmai Thi Ta O.D.

NPI 1003954033 - Optometrist - 152W00000X

NPI Details
NPI 1003954033
Gender Female
Enumeration Date 02/02/2007
Last Updated 03/13/2008
Entity Type Individual
Active Over 9 years ago
Practice Location
2718 NICOLLET AVE
SUITE NO. 103
MINNEAPOLIS MN, 55408-1648, US
Phone (612) 871-1518
Fax (612) 871-2585
Business Location
12167 CARTWAY CURV
EDEN PRAIRIE MN, 55347-4254, US
Phone (612) 871-1518
Fax (612) 871-2525
Toxanomy
Taxonomy Code 152W00000X
License State Minnesota
License Number T2107
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According to our database, Dr. Xuanmai Thi Ta O.D. NPI is 1003954033, taxonomy code is 152W00000X and license number is T2107, license state is located at Minnesota. Xuanmai Thi Ta O.D. physically located at 2718 Nicollet Ave, Minneapolis MN, 55408-1648. NPI Number Xuanmai Thi Ta O.D. has the Individual type.

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1003954033 NPI number is provided on an as is basis without warranty of any kind. 1003954033 is maintained by the National Plan & Provider Enumeration System. The contents of Xuanmai Thi Ta O.D. are for informational purposes only.