Healthcare Provider Details

I. General information

NPI: 1316428725
Provider Name (Legal Business Name): BELDING FAMILY EYECARE LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 08/23/2018
Last Update Date: 08/23/2018
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

936 W STATE ST
BELDING MI
48809-9244
US

IV. Provider business mailing address

936 W STATE ST
BELDING MI
48809-9244
US

V. Phone/Fax

Practice location:
  • Phone: 616-794-9088
  • Fax: 616-794-9084
Mailing address:
  • Phone: 616-794-9088
  • Fax: 616-794-9084

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code152W00000X
TaxonomyOptometrist
License Number4901004807
License Number StateMI

VIII. Authorized Official

Name: DR. THEODORE F SEES
Title or Position: OPTOMETRIST/MANAGER
Credential: OD
Phone: 202-308-4796