NPI 1720316409

David G Gaustad

Practitioner Optician Fergus Falls, MN

Practice location

Address: 615 S Mill St Suite 2, Fergus Falls, MN 56537-2756
Phone: (218) 998-2020
Fax: (218) 998-2098
Mailing address: 2930 Lakewood Dr, Fergus Falls, MN 56537-3948

Registered specialties

Optician Primary

Eye and Vision Services Providers Taxonomy 156FX1800X Licence 025206 (MN)

Other Technician/Technologist providers in Minnesota →

Registry record

NPI: 1720316409
Entity type: Individual
Sex (as registered): Male
NPI issued: 18 Nov 2009
Record last updated: 18 Nov 2009

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.