Healthcare Provider Details

I. General information

NPI: 1801383260
Provider Name (Legal Business Name): VISION THERAPY INSTITUTE OF MI, LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 04/20/2018
Last Update Date: 04/20/2018
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

330 W LAKE LANSING RD
EAST LANSING MI
48823-8527
US

IV. Provider business mailing address

310 W LAKE LANSING RD
EAST LANSING MI
48823-1438
US

V. Phone/Fax

Practice location:
  • Phone: 517-337-8182
  • Fax:
Mailing address:
  • Phone: 517-337-8182
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code152WV0400X
TaxonomyVision Therapy Optometrist
License Number
License Number State

VIII. Authorized Official

Name: CHERYL VINCENT-RIEMER
Title or Position: PRESIDENT
Credential: OD
Phone: 517-337-8182