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NPI Code Detail

MEDICARE: ASHLEY EVE KAMANN O.D.

MEDICARE: ASHLEY EVE KAMANN O.D.
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1152W00000XOptometrist2623OK

General Provider Information

NPI Number : 1033340401
Entity Type Code : Individual
Provider Name (Legal Business Name) : ASHLEY EVE KAMANN O.D.
Provider Business Mailing Address
First Line : 2860 E BELTLINE AVE NE
Second Line :
City : GRAND RAPIDS
State : MI
Zip : 49525-9704
Country : US
Telephone Number : 616-364-8484
Fax Number : 405-350-3072
Provider Business Practice Location Address
First Line : 2860 E BELTLINE AVE NE
Second Line :
City : GRAND RAPIDS
State : MI
Zip : 49525-9704
Country : US
Telephone Number : 616-363-8484
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 08/04/2009
Last Update Date : 07/14/2022

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