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General NPI Number Information
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NPI Number | 1417042276
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Entity Type | Individual
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Provider Name | MARIA LYN-SHOOP GARCIA O.D.
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Gender | Female
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Dates
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Enumeration Date | 10/04/2006
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Last Update Date | 06/03/2022
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Provider Practice Location Address
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Address Line | 800 E CHICAGO ST
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City | COLDWATER
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State | MI
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Zip | 49036-2055
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Country | US
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Telephone | 517-278-2809
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Fax | 517-278-2199
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Provider Business Mailing Address
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Address Line | 172 CHURCH ST
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City | COLDWATER
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State | MI
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Zip | 49036-1756
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Country | US
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Telephone | 269-268-5140
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Fax | 517-278-2199
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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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 | 4901003648
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License Number State | MI
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