Provider Demographics
NPI:1710387477
Name:ANGELA APPLEMAN, OD PLLC
Entity Type:Organization
Organization Name:ANGELA APPLEMAN, OD PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OPTOMETRIST
Authorized Official - Prefix:
Authorized Official - First Name:ANGELA
Authorized Official - Middle Name:
Authorized Official - Last Name:APPLEMAN
Authorized Official - Suffix:
Authorized Official - Credentials:OD
Authorized Official - Phone:217-369-1163
Mailing Address - Street 1:3752 13TH AVE SW
Mailing Address - Street 2:
Mailing Address - City:ROCHESTER
Mailing Address - State:MN
Mailing Address - Zip Code:55902-1661
Mailing Address - Country:US
Mailing Address - Phone:217-369-1163
Mailing Address - Fax:
Practice Address - Street 1:4611 MAINE AVE SE
Practice Address - Street 2:
Practice Address - City:ROCHESTER
Practice Address - State:MN
Practice Address - Zip Code:55904-6929
Practice Address - Country:US
Practice Address - Phone:507-282-6345
Practice Address - Fax:507-282-6392
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2014-09-01
Last Update Date:2014-09-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MN3371152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes152W00000XEye and Vision Services ProvidersOptometristGroup - Single Specialty