Sensory Source, LLC

Primary specialty

Vision Therapy OptometristTaxonomy code 152WV0400X

License

4901003210 Issued in MI

Legal business name

SENSORY SOURCE, LLC

Doing business as

Sensory Learning Center of West Michigan

Practice address

11301 Commerce Dr
Suite a
Allendale, MI 49401-8200

Phone

(616) 895-9550

Fax

(616) 892-5166

NPI assigned

Apr 26, 2007

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Dr. Patricia Marie Roslund, O.D.

Title

Optometrist, LLC Manager

Phone

(616) 895-9550

Specialties & licenses 1

Addresses

Other names 1

• Sensory Learning Center of West Michigan Doing business as

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1177545600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1326268186",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "11301 COMMERCE DR",
            "address_2": "SUITE A",
            "city": "ALLENDALE",
            "state": "MI",
            "postal_code": "494018200",
            "telephone_number": "616-895-9550",
            "fax_number": "616-892-5166"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "11301 COMMERCE DR",
            "address_2": "SUITE A",
            "city": "ALLENDALE",
            "state": "MI",
            "postal_code": "494018200",
            "telephone_number": "616-895-9550",
            "fax_number": "616-892-5166"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SENSORY SOURCE, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-04-26",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "ROSLUND",
        "authorized_official_first_name": "PATRICIA",
        "authorized_official_middle_name": "MARIE",
        "authorized_official_title_or_position": "OPTOMETRIST, LLC MANAGER",
        "authorized_official_telephone_number": "616-895-9550",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "O.D."
    },
    "taxonomies": [
        {
            "code": "152WV0400X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Optometrist, Vision Therapy",
            "state": "MI",
            "license": "4901003210",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Sensory Learning Center of West Michigan",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

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• Vision Therapy Optometrist in Allendale, MI
• Providers in Allendale, MI by specialty
• Vision Therapy Optometrist in Michigan

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.