=====================================================
General NPI Number Information
=====================================================
NPI Number | 1740361427
-----------------------------------------------------
Entity Type | Organization
-----------------------------------------------------
Legal Business Name | KARI VISSER-ROBEL OD PC
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 10/18/2006
-----------------------------------------------------
Last Update Date | 09/30/2025
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 713 S WISCONSIN AVE
-----------------------------------------------------
City | GAYLORD
-----------------------------------------------------
State | MI
-----------------------------------------------------
Zip | 49735-1766
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 989-705-1255
-----------------------------------------------------
Fax | 989-705-1476
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | PO BOX 1220
-----------------------------------------------------
City | GAYLORD
-----------------------------------------------------
State | MI
-----------------------------------------------------
Zip | 49734-5220
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 989-705-1255
-----------------------------------------------------
Fax | 989-705-1476
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position | OWNER
-----------------------------------------------------
Name | KARI MARTHA VISSER-ROBEL
-----------------------------------------------------
Credential | O.D.
-----------------------------------------------------
Telephone | 989-705-1255
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 152W00000X
-----------------------------------------------------
Taxonomy Name | Optometrist
-----------------------------------------------------
License Number |
-----------------------------------------------------
License Number State |
-----------------------------------------------------