Moen, Bruce Allen
Moen, Bruce Allen is an individual health care provider with primary practice located at 1100 31St Ave Sw Suite 2, Minot ND 58701-2007. He recently has only one registered license in Eye and Vision Services Providers / Optometrist, which is considered as his primary health care specialty. Moen, Bruce Allen can be contacted via phone (701) 837-0022.Contact Information
Primary practice address
1100 31St Ave Sw Suite 2
Minot ND 58701-2007
Phone: (701) 837-0022
Fax: (701) 839-2005
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Eye and Vision Services Providers / Optometrist | 152W00000X | 429 | North Dakota |
Profile Details
| NPI number | 1588694194 |
|---|---|
| LBN Legal business name | Moen, Bruce Allen |
| Credentials | Doctor of Optometry (OD) |
| Entity | Individual |
| Sole proprietor 1 | No |
| Enumeration date | Jul 3rd, 2006 |
| Last updated | Oct 5th, 2007 - about 18 years ago |
1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1588694194 | NPPES |
| North Dakota | MEDICAID | 60328 |
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