Kittelson, Richard Neal

Kittelson, Richard Neal is an sole proprietor health care provider with primary practice located at 918 Washington Ave , Detroit Lakes MN 56501-3402. He recently has only one registered license in Eye and Vision Services Providers / Optician, which is considered as his primary health care specialty. Kittelson, Richard Neal can be contacted via phone (218) 847-8021.

Contact Information

Primary practice address
918 Washington Ave Detroit Lakes MN 56501-3402
Phone: (218) 847-8021
Fax: (218) 846-9552
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Eye and Vision Services Providers / Optician 156FX1800X 03590 Minnesota

Profile Details

NPI number 1790942332
LBN Legal business name Kittelson, Richard Neal
Credentials ABOC
Entity Individual
Sole proprietor 1 Yes
Enumeration date May 21st, 2008
Last updated Mar 7th, 2012 - about 12 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.

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Identifiers

StateTypeNumberIssuer
All States NPI 1790942332 NPPES
Minnesota Other 1C991OP BLUE CROSS BLUE SHIELD OF MINNESOTA
Minnesota MEDICAID 498762400 BLUE CROSS BLUE SHIELD OF MINNESOTA
Minnesota Other 2100679 BLUE CROSS BLUE SHIELD OF MINNESOTA

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