Provider Demographics
NPI:1225657067
Name:HO, VIGINIA (OD)
Entity Type:Individual
Prefix:
First Name:VIGINIA
Middle Name:
Last Name:HO
Suffix:
Gender:F
Credentials:OD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4727 ASHTON CURV
Mailing Address - Street 2:
Mailing Address - City:WOODBURY
Mailing Address - State:MN
Mailing Address - Zip Code:55129-1900
Mailing Address - Country:US
Mailing Address - Phone:626-297-1432
Mailing Address - Fax:
Practice Address - Street 1:14050 BURNHAVEN DR
Practice Address - Street 2:
Practice Address - City:BURNSVILLE
Practice Address - State:MN
Practice Address - Zip Code:55337-4407
Practice Address - Country:US
Practice Address - Phone:952-229-6462
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2020-04-12
Last Update Date:2023-08-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MN3694152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152W00000XEye and Vision Services ProvidersOptometrist