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General NPI Number Information
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NPI Number | 1801802616
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Entity Type | Organization
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Legal Business Name | DAVID W. OOSTING OPTOMETRIST INC
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Dates
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Enumeration Date | 08/01/2006
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Last Update Date | 04/13/2015
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Provider Practice Location Address
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Address Line | 9 W MAIN ST BOX 10
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City | FREMONT
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State | MI
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Zip | 49412-1135
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Country | US
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Telephone | 231-924-9870
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Fax | 231-924-6307
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Provider Business Mailing Address
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Address Line | 9 W MAIN ST BOX 10
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City | FREMONT
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State | MI
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Zip | 49412-1135
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Country | US
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Telephone | 231-924-9870
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Fax | 231-924-6307
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Authorized Official
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Title or Position | PRESIDENT
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Name | DR. DAVID W. OOSTING
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Credential | O.D.
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Telephone | 231-924-9870
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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 | 4901002490
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License Number State | MI
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