| NPI | 1417148669 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | STACY HIEMSTRA Office Manager 269-382-6500 |
| Organization Subpart ? | No |
| Primary Taxonomy | 152W00000X Optometrist (Licence: MI 4901002237) |
| Additional Taxonomies | 152W00000X Optometrist (Licence: MI 4901002440) |
| 152W00000X Optometrist (Licence: MI 4901004197) | |
| 152W00000X Optometrist (Licence: MI 4901002352) | |
| Enumeration Date | 2007-08-05 |
| Last Update Date | 2024-05-29 |