NPI 1316102643

Sara Rae Betterly Wallen

Practitioner Optometrist Prior Lake, MN

Practice location

Address: 2330 Sioux Trl NW, Prior Lake, MN 55372-9077
Phone: (952) 233-2955
Mailing address: 712 Hague Ave APT 2, Saint Paul, MN 55104-6951

Registered specialties

Optometrist Primary

Eye and Vision Services Providers Taxonomy 152W00000X Licence 3116 (MN)

Other Optometrist providers in Minnesota →

Registry record

NPI: 1316102643
Entity type: Individual
Sex (as registered): Female
NPI issued: 25 Jul 2008
Record last updated: 25 Jul 2008

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.