Healthcare Provider Details

I. General information

NPI: 1336602911
Provider Name (Legal Business Name): ZENVISION
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 04/10/2019
Last Update Date: 06/09/2025
Certification Date: 06/09/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1905 ABBOT RD STE 1
EAST LANSING MI
48823-8571
US

IV. Provider business mailing address

1905 ABBOT RD STE 1
EAST LANSING MI
48823-8571
US

V. Phone/Fax

Practice location:
  • Phone: 517-580-8733
  • Fax: 517-337-1854
Mailing address:
  • Phone: 517-580-8733
  • Fax: 517-337-1854

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code152W00000X
TaxonomyOptometrist
License Number
License Number State

VIII. Authorized Official

Name: DR. KEVIN MICHAEL JACOBS
Title or Position: CEO/OWNER
Credential: OD
Phone: 517-580-8733