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General NPI Number Information
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NPI Number | 1821001389
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Entity Type | Individual
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Provider Name | LORI ANN SMOLINSKI O.D.
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Gender | Female
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Dates
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Enumeration Date | 08/15/2006
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Last Update Date | 04/01/2021
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Provider Practice Location Address
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Address Line | 456 CHERRY ST SE
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City | GRAND RAPIDS
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State | MI
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Zip | 49503-4626
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Country | US
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Telephone | 616-458-1187
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Fax | 616-458-7113
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Provider Business Mailing Address
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Address Line | 42 COUNTRY CLUB RD
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City | HOLLAND
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State | MI
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Zip | 49423-6605
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Country | US
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Telephone | 616-403-2990
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Fax | 616-458-7113
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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 | 152WL0500X
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Taxonomy Name | Low Vision Rehabilitation Optometrist
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License Number | 4901004066
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License Number State | MI
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