Home » Minnesota » 55616 » Blustin Optical Center Dba Derin J Van Loon, O.d.

Blustin Optical Center Dba Derin J Van Loon, O.d.

Blustin Optical Center Dba Derin J Van Loon, O.d. is a health care provider in Two Harbors, MN. In this page you will find its mailing address, practice location, phone number, specialty etc.

physician-icon Basic Information

Practice Location 802 11th St, Ste A, Two Harbors, MN 55616-1413, US
Practice Location Phone218-834-8070
Practice Location Fax
Legal Business NameBLUSTIN OPTICAL CENTER DBA DERIN J VAN LOON, O.D.
NPI ?1629137419
Entity TypeOrganization
Enumeration Date ? Dec 7, 2006
Last Update Date ? Jul 8, 2007
Note:
NPI: National Provider Identifier issued to health care providers by Centers for Medicare and Medicaid Services (CMS).

specialty-icon Specialties & Licenses of Blustin Optical Center Dba Derin J Van Loon, O.d.

SpecialtySpecializationLicenseLicense State
Technician/TechnologistOptician Minnesota

legacy-id-icon Legacy Provider IDs of Blustin Optical Center Dba Derin J Van Loon, O.d.

Provider IdIssuer StateIssuer TypeIssuer
122437MinnesotaOtherU CARE
2122765MinnesotaOtherMEDICA
5506010002MinnesotaOtherDMERC
74123BLMinnesotaOtherBCBS OF MN

official-icon Authorized Official of Blustin Optical Center Dba Derin J Van Loon, O.d.

An authorized official is an appointed official with the legal authority to make changes and/or updates to the Blustin Optical Center Dba Derin J Van Loon, O.d.'s status and to commit the provider to fully abide by the laws and regulations relating to the National Provider Identifier (NPI).

Authorized Official Mrs. Anne C Anderson
Authorized Official Title/PositionMANAGER
Authorized Official Phone Number218-834-8070