Professional Eyecare of West Michigan LLC
NPI #1467786822 in Grand Rapids, Michigan
Provider Information
- NPI Number
- 1467786822
- Entity Type
- Organization
- Organization Name
- Professional Eyecare of West Michigan LLC
- Primary Specialty
- Optometrist
- Enumeration Date
- Oct 1, 2009
- Last Updated
- Jun 8, 2010
Practice Location
- Address
- 6750 KALAMAZOO AVE SE
- Address 2
- SUITE C
- City
- Grand Rapids
- State
- Michigan
- ZIP Code
- 49508-7897
- Phone
- (616) 656-0505
Authorized Official
- Name
- DR. TROY LEBARON, O.D.
- Title
- MEMBER
- Phone
- (616) 334-9255
Specialties & Taxonomy Codes
| Specialty |
|---|
| Optometrist |
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