NPI 1922119486

Richard David Bruesch, OD

Practitioner Optometrist Forest Lake, MN

Practice location

Address: 200 12th St SW, Forest Lake, MN 55025-1482
Phone: (651) 464-9767
Mailing address: 13941 Redwood St NW, Andover, MN 55304-4135

Registered specialties

Optometrist Primary

Eye and Vision Services Providers Taxonomy 152W00000X Licence 2622 (MN)

Other Optometrist providers in Minnesota →

Registry record

NPI: 1922119486
Entity type: Individual
Sex (as registered): Male
NPI issued: 31 Aug 2006
Record last updated: 9 Jul 2007

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.