Healthcare Provider Details
I. General information
NPI: 1558401893
Provider Name (Legal Business Name): SCHMITZER EYECARE, P.C.
Entity Type: Organization
Gender:
Sole Proprietor:
II. Dates (important events)
Enumeration Date: 02/07/2007
Last Update Date: 09/14/2010
Certification Date:
Deactivation Date:
Reactivation Date:
III. Provider practice location address
11973 SWEETWATER DR
GRAND LEDGE MI
48837-9196
US
IV. Provider business mailing address
11973 SWEETWATER DR
GRAND LEDGE MI
48837-9196
US
V. Phone/Fax
- Phone: 517-622-2020
- Fax: 517-627-4397
- Phone: 517-622-2020
- Fax: 517-627-4397
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 152W00000X |
| Taxonomy | Optometrist |
| License Number | |
| License Number State | |
VIII. Authorized Official
Name: DR.
ANDREW
H.
SCHMITZER
Title or Position: OPTOMETRIST, PRESIDENT
Credential: O.D.
Phone: 517-622-2020