Goodwill Optical INC

NPI #1508034711 in Grand Rapids, Michigan

Provider Information

NPI Number: 1508034711
Entity Type: Organization
Organization Name: Goodwill Optical INC
Primary Specialty: Optometrist
Enumeration Date: Feb 11, 2008
Last Updated: Feb 11, 2008

Practice Location

Address: 1655 4 MILE RD NE
City: Grand Rapids
State: Michigan
ZIP Code: 49525-2438
Phone: (616) 447-0489

Authorized Official

Name: TIMOTHY D WESTRA
Title: PRESIDENT
Phone: (616) 846-0620

Specialties & Taxonomy Codes

Specialty	Taxonomy Code	Primary
Optometrist	152W00000X	Primary

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