NPI 1114948734

Courtney Ray Sivertson, OD

Practitioner Optometrist Rochester, MN

Practice location

Address: 3632 10th Ln NW, Rochester, MN 55901-7032
Phone: (507) 282-7121

Registered specialties (3)

Optometrist Primary

Eye and Vision Services Providers Taxonomy 152W00000X Licence 3070 (MN)

Other Optometrist providers in Minnesota →

Optometrist

Eye and Vision Services Providers Taxonomy 152W00000X Licence 6246453-9934 (UT)

Corneal and Contact Management Optometrist

Eye and Vision Services Providers Taxonomy 152WC0802X Licence 3070 (MN)

Registry record

NPI: 1114948734
Entity type: Individual
Sex (as registered): Male
NPI issued: 21 Jul 2006
Record last updated: 19 Jul 2012

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.