Provider Demographics
NPI:1629417662
Name:WENDLANDT, PAMELA J (OD)
Entity Type:Individual
Prefix:DR
First Name:PAMELA
Middle Name:J
Last Name:WENDLANDT
Suffix:
Gender:F
Credentials:OD
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Mailing Address - Street 1:15704 90TH ST NE
Mailing Address - Street 2:SUITE 100
Mailing Address - City:OTSEGO
Mailing Address - State:MN
Mailing Address - Zip Code:55330-7448
Mailing Address - Country:US
Mailing Address - Phone:763-241-1090
Mailing Address - Fax:763-241-1091
Practice Address - Street 1:15704 90TH ST NE
Practice Address - Street 2:SUITE 100
Practice Address - City:OTSEGO
Practice Address - State:MN
Practice Address - Zip Code:55330-7448
Practice Address - Country:US
Practice Address - Phone:763-241-1090
Practice Address - Fax:763-241-1091
Is Sole Proprietor?:No
Enumeration Date:2013-06-24
Last Update Date:2013-06-24
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
MN3354152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152W00000XEye and Vision Services ProvidersOptometrist