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General NPI Number Information
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NPI Number | 1376759738
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Entity Type | Organization
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Legal Business Name | BIG RAPIDS FAMILY EYE CARE PLLC
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Dates
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Enumeration Date | 05/15/2007
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Last Update Date | 01/05/2024
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Provider Practice Location Address
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Address Line | 207 S MICHIGAN AVE
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City | BIG RAPIDS
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State | MI
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Zip | 49307-1809
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Country | US
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Telephone | 231-796-5321
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Fax | 231-796-2957
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Provider Business Mailing Address
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Address Line | 207 S MICHIGAN AVE
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City | BIG RAPIDS
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State | MI
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Zip | 49307-1809
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Country | US
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Telephone | 231-796-5321
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Fax | 231-796-2957
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Authorized Official
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Title or Position | OPTOMETRIST
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Name | MRS. EMILY ANNE COLES
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Credential | O.D.
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Telephone | 231-796-5321
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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 |
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License Number State |
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