| NPI | 1609959089 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | SCOTT RICHARD ECENBARGER Optometrist 616-532-2020 |
| Organization Subpart ? | No |
| Primary Taxonomy | 152W00000X Optometrist (Licence: MI currently applying) |
| Enumeration Date | 2006-10-22 |
| Last Update Date | 2020-08-22 |