| NPI | 1003237082 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | AMANDA M BECK Insurance Biller 616-846-0620 |
| Organization Subpart ? | No |
| Primary Taxonomy | 152WV0400X Optometrist, Vision Therapy (Licence: MI 4901002642) |
| Enumeration Date | 2013-12-18 |
| Last Update Date | 2013-12-18 |