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Individual

DR. ROCKY G HANSEN

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
OD

Contact information

Practice address
307 S FRANKLIN, GREENVILLE, MI 48838-1905
(616) 754-7143
(616) 754-2778
Mailing address
307 S FRANKLIN ST, GREENVILLE, MI 48838-1759
(616) 754-7143
(616) 754-2778

Taxonomy

Speciality
Code
Description
License number
State
152W00000X
Optometrist
Primary
4901002646
MI

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
01256
PRIORITY HEALTH
MI
05
943153415
MI
01
RH002646
BLUE CROSS BLUE SHIELD
MI
Enumeration date
10/07/2005
Last updated
02/07/2020
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