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General NPI Number Information
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NPI Number | 1790828622
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Entity Type | Organization
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Legal Business Name | LAINGSBURG EYE CARE P.C.
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Dates
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Enumeration Date | 02/14/2007
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Last Update Date | 04/01/2008
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Provider Practice Location Address
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Address Line | 252 E GRAND RIVER RD
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City | LAINGSBURG
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State | MI
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Zip | 48848-8600
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Country | US
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Telephone | 517-651-6608
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Fax | 517-651-6603
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Provider Business Mailing Address
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Address Line | 252 E GRAND RIVER RD PO BOX 218
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City | LAINGSBURG
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State | MI
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Zip | 48848-8600
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Country | US
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Telephone | 517-651-6608
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Fax | 517-651-6603
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Authorized Official
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Title or Position | OPTOMETRIST,OWNER
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Name | DR. MARSHA A BRANDON
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Credential | O.D.
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Telephone | 517-651-6608
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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 | MB003617
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License Number State | MI
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