Provider Demographics
NPI:1215063961
Name:DR.STEPHEN P. TONNER OPT. LTD.
Entity type:Organization
Organization Name:DR.STEPHEN P. TONNER OPT. LTD.
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:STEPHEN
Authorized Official - Middle Name:P
Authorized Official - Last Name:TONNER
Authorized Official - Suffix:
Authorized Official - Credentials:OD
Authorized Official - Phone:952-224-2883
Mailing Address - Street 1:8053 E BLOOMINGTON FWY
Mailing Address - Street 2:SUITE 550
Mailing Address - City:BLOOMINGTON
Mailing Address - State:MN
Mailing Address - Zip Code:55420-1002
Mailing Address - Country:US
Mailing Address - Phone:952-224-2883
Mailing Address - Fax:952-224-2885
Practice Address - Street 1:8053 E BLOOMINGTON FWY
Practice Address - Street 2:SUITE 550
Practice Address - City:BLOOMINGTON
Practice Address - State:MN
Practice Address - Zip Code:55420-1002
Practice Address - Country:US
Practice Address - Phone:952-224-2883
Practice Address - Fax:952-224-2885
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-02-26
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MN2336332H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332H00000XSuppliersEyewear Supplier