NPI 1003438797

Jacob Victor Sander, ODMS

Practitioner Optometrist Shakopee, MN

Practice location

Address: 1455 Saint Francis Ave, Shakopee, MN 55379-3374
Phone: (952) 993-3150
Mailing address: 8170 33rd Ave S # Ms 21110q, Bloomington, MN 55425-4516

Registered specialties

Optometrist Primary

Eye and Vision Services Providers Taxonomy 152W00000X Licence 3677 (MN)

Other Optometrist providers in Minnesota →

Registry record

NPI: 1003438797
Entity type: Individual
Sex (as registered): Male
NPI issued: 15 May 2020
Record last updated: 1 Jul 2021

Reproduced from NPPES, the federal provider registry. The date above is when the provider last updated their own entry, not when we fetched it - a record can be years old and still current in the registry.