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General NPI Number Information
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NPI Number | 1598934150
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Entity Type | Organization
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Legal Business Name | CEDAR SPRINGS EYE CARE INC
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Dates
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Enumeration Date | 02/27/2008
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Last Update Date | 03/08/2013
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Provider Practice Location Address
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Address Line | 26 S MAIN
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City | CEDAR SPRINGS
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State | MI
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Zip | 49319-5118
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Country | US
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Telephone | 616-696-0830
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Fax | 616-696-4724
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Provider Business Mailing Address
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Address Line | 26 S MAIN P.O. BOX 683
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City | CEDAR SPRINGS
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State | MI
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Zip | 49319-8936
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Country | US
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Telephone | 616-696-0830
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Fax | 616-696-4724
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Authorized Official
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Title or Position | OPTOMETRIST
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Name | DR. SCOTT L SCHOMAKER
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Credential | O.D.
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Telephone | 616-696-0830
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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 | 4901003121
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License Number State | MI
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