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General NPI Number Information
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NPI Number | 1427183359
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Entity Type | Organization
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Legal Business Name | OPTOMETRISTS OF LANSING PC
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Dates
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Enumeration Date | 02/22/2007
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Last Update Date | 11/09/2012
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Provider Practice Location Address
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Address Line | 2117 E GRAND RIVER AVE
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City | LANSING
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State | MI
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Zip | 48912-3231
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Country | US
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Telephone | 517-485-2213
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Fax | 517-485-2220
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Provider Business Mailing Address
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Address Line | 2117 E GRAND RIVER AVE
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City | LANSING
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State | MI
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Zip | 48912-3231
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Country | US
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Telephone | 517-485-2213
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Fax | 517-485-2220
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Authorized Official
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Title or Position | PRESIDENT
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Name | DR. RICHARD CARRIGAN
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Credential | D.O.
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Telephone | 517-485-2213
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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 | KM002606
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License Number State | MI
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Taxonomy #2
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Taxonomy Code | 152W00000X
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Taxonomy Name | Optometrist
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License Number | SE003722
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License Number State | MI
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Taxonomy #3
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Taxonomy Code | 152W00000X
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Taxonomy Name | Optometrist
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License Number | RC002397
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License Number State | MI
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