NPI 1083380653

Samantha Illsley

Practitioner Technician/Technologist Saint Cloud, MN

Practice location

Address: 141 33rd Ave S, Saint Cloud, MN 56301-3753
Phone: (320) 443-6250

Registered specialties

Technician/Technologist Primary

Eye and Vision Services Providers Taxonomy 156F00000X

Other Technician/Technologist providers in Minnesota →

Registry record

NPI: 1083380653
Entity type: Individual
Sex (as registered): Female
NPI issued: 23 Aug 2021
Record last updated: 23 Aug 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.