Vandesteeg & Larson Optometric Clinic PA
Organization Active NPI Optometrist · Glenwood, MN
NPI 1922401694 · NPPES record last updated Jul 16, 2025
Key facts
- NPI
- 1922401694
- Entity type
- Organization (NPI type 2)
- Primary specialty
- Optometrist 152W00000X
- License
- 1709 (MN)
- Legal business name
- VANDESTEEG & LARSON OPTOMETRIC CLINIC PA
- Practice address
- 24 1St St SE
Glenwood, MN 56334-1619 - Phone
- (320) 634-4516
- Fax
- (320) 634-4520
- NPI assigned
- Oct 8, 2014
- Organization subpart
- No
Authorized official
- Name
- Jonathan M Larson, OD
- Title
- Owner
- Phone
- (320) 634-4516
Corporate family (same tax ID) 2
National Provider Directory
- Tax ID family
- Vandesteeg Larson Optomet
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Optometrist |
152W00000X | 1709 | MN | Yes |
| Eyewear Supplier | 332H00000X |
Addresses
Primary practice location
24 1St St SE
Glenwood, MN 56334-1619
Mailing address
24 1St St SE
Glenwood, MN 56334-1619
Phone (320) 634-4516
Other names
- Glacial Ridge Eye Clinic
Other providers in Glenwood, MN
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Jul 16, 2025. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.