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General NPI Number Information
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NPI Number | 1114373727
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Entity Type | Organization
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Legal Business Name | LINDEN FAMILY EYECARE PC
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Dates
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Enumeration Date | 05/12/2016
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Last Update Date | 05/12/2016
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Provider Practice Location Address
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Address Line | 123 E BROAD ST
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City | LINDEN
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State | MI
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Zip | 48451-9126
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Country | US
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Telephone | 810-735-9988
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Fax |
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Provider Business Mailing Address
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Address Line | 7143 W ROLSTON RD
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City | LINDEN
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State | MI
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Zip | 48451-9766
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Country | US
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Telephone | 810-735-9988
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Fax |
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Authorized Official
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Title or Position | PRESIDENT/SECRETARY
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Name | DR. GERIANNE J MULANIX
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Credential | OD
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Telephone | 810-656-9713
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 152WL0500X
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Taxonomy Name | Low Vision Rehabilitation Optometrist
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License Number | 4901004592
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License Number State | MI
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