Maria Lyn Shoop Davenport O.D.

NPI 1417042276 - Optometrist - 152W00000X

NPI Details
NPI 1417042276
Gender Female
Enumeration Date 10/04/2006
Last Updated 03/12/2016
Entity Type Individual
Active Over 10 years ago
Practice Location
124 E PRAIRIE ST
VICKSBURG MI, 49097-1257, US
Phone (269) 649-0103
Fax (269) 649-4762
Business Location
124 E PRAIRIE ST
VICKSBURG MI, 49097-1257, US
Phone (269) 649-0103
Fax (269) 649-4762
Toxanomy
Taxonomy Code 152W00000X
License State Michigan
License Number 4901003648
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According to our database, Dr. Maria Lyn Shoop Davenport O.D. NPI is 1417042276, taxonomy code is 152W00000X and license number is 4901003648, license state is located at Michigan. Maria Lyn Shoop Davenport O.D. physically located at 124 E Prairie St, Vicksburg MI, 49097-1257. NPI Number Maria Lyn Shoop Davenport O.D. has the Individual type.

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1417042276 NPI number is provided on an as is basis without warranty of any kind. 1417042276 is maintained by the National Plan & Provider Enumeration System. The contents of Maria Lyn Shoop Davenport O.D. are for informational purposes only.