Healthcare Provider Details

I. General information

NPI: 1730201443
Provider Name (Legal Business Name): I CARE VISION CENTER INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 04/04/2007
Last Update Date: 12/22/2016
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

10344 THOR DR SUITE B
FREELAND MI
48623-8430
US

IV. Provider business mailing address

10344 THOR DR SUITE B
FREELAND MI
48623-8430
US

V. Phone/Fax

Practice location:
  • Phone: 989-692-2020
  • Fax: 989-692-2021
Mailing address:
  • Phone: 989-692-2020
  • Fax: 989-692-2021

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code152W00000X
TaxonomyOptometrist
License Number4901003682
License Number StateMI

VIII. Authorized Official

Name: DR. YVONNE M KWAPIS
Title or Position: OWNER
Credential: OD
Phone: 989-692-2020