Healthcare Provider Details

I. General information

NPI: 1356323372
Provider Name (Legal Business Name): LESLEY LYNN LENAHAN FINKBEINER
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: LESLEY LYNN LENAHAN OD

II. Dates (important events)

Enumeration Date: 11/16/2005
Last Update Date: 11/07/2016
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

304 W HOUGHTON AVE
WEST BRANCH MI
48661-1222
US

IV. Provider business mailing address

2186 PEACH LAKE RD
WEST BRANCH MI
48661-9361
US

V. Phone/Fax

Practice location:
  • Phone: 989-345-2020
  • Fax: 989-345-1281
Mailing address:
  • Phone: 989-220-5506
  • Fax: 989-345-1281

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code152W00000X
TaxonomyOptometrist
License Number4901003637
License Number StateMI

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: