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David G Gaustad
Optician in Fergus Falls, Minnesota
NPI 1720316409

David G Gaustad is a Optician based in Fergus Falls, MN and is specialized in Optician. David G Gaustad practices in Fergus Falls, MN. The NPI Number for David G Gaustad is 1720316409 and holds a License No. 025206 (Minnesota).

The current practice location address for David G Gaustad is 615 S Mill St, Fergus Falls, MN and can be reached out via phone at 218-998-2020 and via fax at 218-998-2098. You can also correspond with David G Gaustad through the mailing address at 2930 LAKEWOOD DR, FERGUS FALLS, MN - 56537-3948 (mailing address contact number: 218-736-4089).

Location: 615 S Mill St, Fergus Falls, MN, 56537-3948
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Provider Profile Details
NPI Number
1720316409
Provider Name
David G Gaustad
Credential
Provider Entity Type
Individual
Gender
Male
Address
615 S Mill St, Fergus Falls, MN, 56537-3948
Phone Number
218-998-2020
Fax Number
218-998-2098
Provider Enumeration Date
11/18/2009
Last Update Date
03/09/2024
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Provider's Legacy Identifiers
Identifier Type State Issuer
4C853GA 01 MN BLUE CROSS BLUE SHIELD OF MN
institution
Provider Business Practice Location Address Details
Address
615 S Mill St
City
State
Zip
56537-2756
Phone Number
218-998-2020
Fax Number
218-998-2098
person
Provider Business Mailing Address Details
Address
2930 Lakewood Dr
City
State
Zip
56537-3948
Phone Number
218-736-4089
Fax Number
person
Provider's Taxonomy Details 1
Type
Eye and Vision Services Providers
Classification
Technician/Technologist
Speciality
Optician
Taxonomy
License No.
025206 (Minnesota)
Definition
Definition to come...
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