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General NPI Number Information
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NPI Number | 1124377163
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Entity Type | Organization
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Legal Business Name | VISION AND SENSORY CENTER OF MICHIGAN LLC
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Dates
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Enumeration Date | 09/06/2012
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Last Update Date | 09/06/2012
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Provider Practice Location Address
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Address Line | 4467 BYRON CENTER AVE.
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City | WYOMING
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State | MI
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Zip | 49519
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Country | US
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Telephone | 616-534-4953
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Fax | 616-534-9790
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Provider Business Mailing Address
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Address Line | 4467 BYRON CENTER AVE.
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City | WYOMING
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State | MI
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Zip | 49519
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Country | US
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Telephone | 616-534-4953
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Fax |
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Authorized Official
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Title or Position | OWNER
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Name | DR. ROBERT ARTHUR HOHENDORF
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Credential | O.D.
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Telephone | 616-534-4953
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 152W00000X
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Taxonomy Name | Optometrist
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License Number | 4901002522
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License Number State | MI
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