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General NPI Number Information
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NPI Number | 1588993422
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Entity Type | Organization
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Legal Business Name | CORNERSTONE OPTOMETRY PLLC
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Dates
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Enumeration Date | 12/23/2009
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Last Update Date | 02/21/2010
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Provider Practice Location Address
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Address Line | 3285 HENRY ST TODD J. RIKER, O.D. / VISION CENTER
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City | MUSKEGON
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State | MI
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Zip | 49441-4019
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Country | US
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Telephone | 231-739-4728
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Fax | 231-739-4730
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Provider Business Mailing Address
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Address Line | 2221 BLISSFIELD CT
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City | NORTON SHORES
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State | MI
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Zip | 49441-4413
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Country | US
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Telephone | 231-733-5530
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Fax | 231-733-5585
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Authorized Official
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Title or Position | OWNER
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Name | TODD JAMES RIKER
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Credential | O.D.
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Telephone | 231-733-5530
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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 | 4901004230
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License Number State | MI
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