| |
1335 W Main St, Suite A, Lowell, MI 49331-1555 | |
(616) 897-7000 | |
(616) 897-5604 |
Full Name | |
---|---|
Type | Facility |
Speciality | Ophthalmology |
Location | 1335 W Main St, Lowell, Michigan |
Accepts Medicare Assignments | Does not participate in Medicare Program. The facility may not accept medicare assignment. |
Identifier | Type | State | Issuer |
---|---|---|---|
1841483989 | NPI | - | NPPES |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
152W00000X | Optometrist | 4901004379 (Michigan) | Secondary |
152W00000X | Optometrist | 4901004439 (Michigan) | Secondary |
207W00000X | Ophthalmology | 4901004379 (Michigan) | Primary |
Mailing Address | Practice Location Address |
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1335 W Main St, Suite A, Lowell, MI 49331-1555 Ph: (616) 897-7000 | 1335 W Main St, Suite A, Lowell, MI 49331-1555 Ph: (616) 897-7000 |