Coopersville Vision Center PC

Organization Active NPI Optometrist · Coopersville, MI

NPI 1699816124 · NPPES record last updated Apr 29, 2008

Key facts

NPI
1699816124
Entity type
Organization (NPI type 2)
Primary specialty
Optometrist 152W00000X
License
4901002956 (MI)
Legal business name
COOPERSVILLE VISION CENTER PC
Practice address
692 W Randall St
Coopersville, MI 49404-1306
Phone
(616) 837-6847
Fax
(616) 837-9338
NPI assigned
Feb 9, 2007
Organization subpart
No

Authorized official

Name
Dawn K Walt, OD
Title
Owner
Phone
(616) 837-6847

Practitioners 2

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

National Provider Directory

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Optometrist
Group: 193200000X MULTI-SPECIALTY GROUP
152W00000X 4901002956 MI Yes

Addresses

Primary practice location

692 W Randall St
Coopersville, MI 49404-1306

Mailing address

692 W Randall St
Coopersville, MI 49404-1306
Phone (616) 837-6847

Other providers in Coopersville, MI

All providers in Coopersville, MI · Optometrist in Michigan

Sources for this page

Verify at the official NPI Registry.