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General NPI Number Information
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NPI Number | 1427134063
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Entity Type | Individual
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Provider Name | KIMBERLY LYNNE GARRISON OD
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Gender | Female
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Dates
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Enumeration Date | 10/27/2006
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Last Update Date | 02/04/2022
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Provider Practice Location Address
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Address Line | 4067 E COURT ST STE 10
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City | BURTON
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State | MI
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Zip | 48509-2509
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Country | US
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Telephone | 810-715-2020
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Fax | 810-715-2021
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Provider Business Mailing Address
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Address Line | 4067 E COURT ST STE 10
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City | BURTON
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State | MI
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Zip | 48509-2509
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Country | US
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Telephone | 810-715-2020
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Fax | 810-715-2021
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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 | 4901003930
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License Number State | MI
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