Healthcare Provider Details

I. General information

NPI: 1255245486
Provider Name (Legal Business Name): ELIZABETH COWDEN OD
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 10/02/2026
Last Update Date: 10/02/2026
Certification Date: 10/02/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

750 E BELTLINE AVE NE
GRAND RAPIDS MI
49525-6049
US

IV. Provider business mailing address

1030 SKYEVALE NE
ADA MI
49301-8125
US

V. Phone/Fax

Practice location:
  • Phone: 877-338-9797
  • Fax:
Mailing address:
  • Phone: 616-570-4766
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code152W00000X
TaxonomyOptometrist
License Number717732
License Number StateMI

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: