Provider Demographics
NPI:1447073796
Name:THRONDSEN, HUNTER RILEY (OD)
Entity type:Individual
Prefix:
First Name:HUNTER
Middle Name:RILEY
Last Name:THRONDSEN
Suffix:
Gender:M
Credentials:OD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2180 TROOP DR
Mailing Address - Street 2:
Mailing Address - City:SARTELL
Mailing Address - State:MN
Mailing Address - Zip Code:56377-4582
Mailing Address - Country:US
Mailing Address - Phone:320-258-3915
Mailing Address - Fax:
Practice Address - Street 1:2180 TROOP DR
Practice Address - Street 2:
Practice Address - City:SARTELL
Practice Address - State:MN
Practice Address - Zip Code:56377-4582
Practice Address - Country:US
Practice Address - Phone:320-258-3915
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-11-05
Last Update Date:2024-11-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MN3964152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152W00000XEye and Vision Services ProvidersOptometrist