Healthcare Provider Details

I. General information

NPI: 1073631040
Provider Name (Legal Business Name): PINCONNING FAMILY EYE CARE PC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 03/27/2007
Last Update Date: 09/03/2015
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1948 N HURON RD
PINCONNING MI
48650-7909
US

IV. Provider business mailing address

1948 N HURON RD P.O. BOX 325
PINCONNING MI
48650-7909
US

V. Phone/Fax

Practice location:
  • Phone: 989-879-3937
  • Fax: 989-879-3981
Mailing address:
  • Phone: 989-879-3937
  • Fax: 989-879-3981

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code152W00000X
TaxonomyOptometrist
License NumberRL003052
License Number StateMI

VIII. Authorized Official

Name: DR. RAYMOND ALLEN LALONDE
Title or Position: OPTOMETRIST
Credential: OD
Phone: 989-879-3937