Provider Demographics
NPI:1891924916
Name:TONEY-VANGRINSVEN, ANGELA M (OPTICIAN)
Entity Type:Individual
Prefix:MRS
First Name:ANGELA
Middle Name:M
Last Name:TONEY-VANGRINSVEN
Suffix:
Gender:F
Credentials:OPTICIAN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5809 EGAN DR
Mailing Address - Street 2:
Mailing Address - City:SAVAGE
Mailing Address - State:MN
Mailing Address - Zip Code:55378-4918
Mailing Address - Country:US
Mailing Address - Phone:612-388-7192
Mailing Address - Fax:
Practice Address - Street 1:5809 EGAN DR
Practice Address - Street 2:
Practice Address - City:SAVAGE
Practice Address - State:MN
Practice Address - Zip Code:55378-4918
Practice Address - Country:US
Practice Address - Phone:612-388-7192
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2009-07-10
Last Update Date:2009-07-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MN156FX1800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes156FX1800XEye and Vision Services ProvidersTechnician/TechnologistOptician