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General NPI Number Information
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NPI Number | 1720574031
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Entity Type | Individual
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Provider Name | LAUREN ASHLEE GOSLIN OD
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Gender | Female
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Dates
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Enumeration Date | 07/10/2018
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Last Update Date | 08/02/2023
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Provider Practice Location Address
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Address Line | 409 W LUDINGTON AVE
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City | LUDINGTON
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State | MI
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Zip | 49431-2377
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Country | US
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Telephone | 231-843-4117
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Fax | 231-843-7631
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Provider Business Mailing Address
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Address Line | 409 W LUDINGTON AVE
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City | LUDINGTON
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State | MI
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Zip | 49431-2377
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Country | US
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Telephone | 231-843-4117
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Fax | 231-843-7631
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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 | 134226
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License Number State | AK
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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 | 4901005608
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License Number State | MI
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