person
Richard Neal Kittelson, ABOC
Optician in Detroit Lakes, Minnesota
NPI 1790942332

Richard Neal Kittelson is a Optician based in Detroit Lakes, MN and is specialized in Optician. Richard Neal Kittelson practices in Detroit Lakes, MN and has the professional credentials of ABOC. The NPI Number for Richard Neal Kittelson is 1790942332 and holds a License No. 03590 (Minnesota).

The current practice location address for Richard Neal Kittelson is 918 Washington Ave, Detroit Lakes, MN and can be reached out via phone at 218-847-8021 and via fax at 218-846-9552.

Location: 918 Washington Ave, Detroit Lakes, MN, 56501-3402
person
Provider Profile Details
NPI Number
1790942332
Provider Name
Richard Neal Kittelson
Credential
ABOC
Provider Entity Type
Individual
Gender
Male
Address
918 Washington Ave, Detroit Lakes, MN, 56501-3402
Phone Number
218-847-8021
Fax Number
218-846-9552
Provider Enumeration Date
05/21/2008
Last Update Date
03/09/2024
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Provider's Legacy Identifiers
Identifier Type State Issuer
1C991OP 01 MN BLUE CROSS BLUE SHIELD OF MINNESOTA
498762400 05 MN
2100679 01 MN MEDICA
institution
Provider Business Practice Location Address Details
Address
918 Washington Ave
City
State
Zip
56501-3402
Phone Number
218-847-8021
Fax Number
218-846-9552
person
Provider Business Mailing Address Details
Address
918 Washington Ave
City
State
Zip
56501-3402
Phone Number
218-847-8021
Fax Number
218-846-9552
person
Provider's Taxonomy Details 1
Type
Eye and Vision Services Providers
Classification
Technician/Technologist
Speciality
Optician
Taxonomy
License No.
03590 (Minnesota)
Definition
Definition to come...
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