Blake Thomas Dirks, OD Valid NPI
Individual provider · Optometrist · Saint Peter, MN
- NPI
- 1629145057
- Type
- Individual (Type 1)
- Primary specialty
- Optometrist
- Specialty group
- Eye and Vision Services Providers
- Taxonomy code
- 152W00000X
- License number
- 2076 (MN)
- Sex
- Male
- Sole proprietor
- Yes
- Enumerated
- 2006-11-29
- Last updated
- 2014-02-14
Practice location
320 Sunrise Dr
Saint Peter, MN 56082-1352
(507) 931-6436