MEDICARE: MARTIN EYE CARE PLLC

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	152W00000X	Optometrist

General Provider Information

NPI Number	:	1992938922
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	MARTIN EYE CARE PLLC

Provider Business Mailing Address
First Line	:	110 S GREENVILLE WEST DR
Second Line	:	SUITE 1
City	:	GREENVILLE
State	:	MI
Zip	:	48838-3560
Country	:	US
Telephone Number	:	616-754-0110
Fax Number	:	616-754-4733

Provider Business Practice Location Address
First Line	:	110 S GREENVILLE WEST DR
Second Line	:	SUITE 1
City	:	GREENVILLE
State	:	MI
Zip	:	48838-3560
Country	:	US
Telephone Number	:	616-754-0110
Fax Number	:	616-754-4733

Authorized Official
Title or Position	:	OWNER
Name	:	RENEE V MARTIN
Credential	:	O.D.
Telephone Number	:	616-754-0110

Provider Enumeration Date	:	08/25/2009
Last Update Date	:	09/04/2013

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Directions to “MARTIN EYE CARE PLLC ” Practice Location

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