Lifetime Eyecare P.c.

NPI 1285836213 - Optometrist - 152W00000X

NPI Details
NPI 1285836213
Enumeration Date 06/01/2007
Last Updated 12/23/2009
Entity Type Healthcare Provider
Active Over 9 years ago
Authorized Information
Name GORDON DALE GORDON
Position PRESIDENT
Phone (616) 457-0760
Fax
Practice Location
597 BALDWIN ST
JENISON MI, 49428-7994, US
Phone (616) 457-0760
Fax
Business Location
597 BALDWIN ST
JENISON MI, 49428-7994, US
Phone (616) 457-0760
Fax
Toxanomy
Taxonomy Code 152W00000X
License State Michigan
License Number 4901002394
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According to our database, Lifetime Eyecare P.c. NPI is 1285836213, taxonomy code is 152W00000X and license number is 4901002394, license state is located at Michigan. Lifetime Eyecare P.c. physically located at 597 Baldwin St, Jenison MI, 49428-7994. NPI Number 1033115704 has the healthcare provider type.

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1285836213 NPI number is provided on an as is basis without warranty of any kind. 1285836213 is maintained by the National Plan & Provider Enumeration System. The contents of Lifetime Eyecare P.c. are for informational purposes only.