Organization · Type 2 NPI

Vandesteeg & Larson Optometric Clinic, PA

Eyewear Supplier · Glenwood, MN

NPI number 1174929160 Active

Practice location

24 1st St SE
Glenwood, MN 56334-1619

Call (320) 634-4516 Map

Fax (320) 634-4520

Mailing address

24 1st Street SE
Glenwood, MN 56334

Specialties and licenses

Taxonomy	Code	License
Durable Medical Equipment & Medical Supplies	332B00000X	None listed
Eyewear Supplier Primary	332H00000X	None listed

Eyewear Supplier: An organization that provides spectacles, contact lenses, and other vision enhancement devices prescribed by an optometrist or ophthalmologist.

3 other providers at this address

NPI record

NPI: 1174929160
Entity type: Organization (Type 2)
Issued: Nov 18, 2014
Last updated: Jul 16, 2025
Status: Active

Other names

<unavail>
Glacial Ridge Eye Clinic · doing business as
Glacial Ridge Eye Clinic · doing business as

Authorized official

Dr. Jonathan D Larson, OD
Owner
(320) 634-4516

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About NPI 1174929160

Vandesteeg & Larson Optometric Clinic, PA's National Provider Identifier is 1174929160, issued on Nov 18, 2014. The primary taxonomy on file is Eyewear Supplier (332H00000X), and the practice location is in Glenwood, MN. The record was last updated on Jul 16, 2025.