Healthcare Provider Details
I. General information
NPI: 1871901892
Provider Name (Legal Business Name): HOUSER DRAPER INVESTMENTS PLLC
Entity Type: Organization
Gender:
Sole Proprietor:
II. Dates (important events)
Enumeration Date: 07/23/2014
Last Update Date: 08/28/2014
Certification Date:
Deactivation Date:
Reactivation Date:
III. Provider practice location address
405 W GREENLAWN AVE SUITE 101
LANSING MI
48910-2898
US
IV. Provider business mailing address
405 W GREENLAWN AVE SUITE101
LANSING MI
48910-2898
US
V. Phone/Fax
- Phone: 517-482-3940
- Fax: 517-482-1324
- Phone: 517-482-3940
- Fax: 517-482-1324
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 152W00000X |
| Taxonomy | Optometrist |
| License Number | 4901004011 |
| License Number State | MI |
VIII. Authorized Official
Name: DR.
BRIAN
J
HOUSER
Title or Position: OWNER
Credential: O.D.
Phone: 517-485-9050