Rancic, Jake David
Rancic, Jake David is an individual health care provider with primary practice located at 144 Tyler Rd N Ste B , Red Wing MN 55066-1889. He recently has only one registered license in Eye and Vision Services Providers / Optometrist, which is considered as his primary health care specialty. Rancic, Jake David can be contacted via phone (651) 388-3838.Contact Information
Primary practice address
144 Tyler Rd N Ste B
Red Wing MN 55066-1889
Phone: (651) 388-3838
Fax: (651) 388-6838
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Eye and Vision Services Providers / Optometrist | 152W00000X | 3751 | Minnesota |
Profile Details
| NPI number | 1770255267 |
|---|---|
| LBN Legal business name | Rancic, Jake David |
| Credentials | Doctor of Optometry (OD) |
| Entity | Individual |
| Sole proprietor 1 | No |
| Enumeration date | Oct 2nd, 2021 |
| Last updated | Oct 2nd, 2021 - about 3 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 | 1770255267 | NPPES |
| Minnesota | Other | MN3751 | STATE LICENSE |
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