Organization
DR. GLEN A. LINSLEY OPTOMETRIST, PC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MRS. MICHELLE HEBERLEIN (MEDICAL BILLER)
(517) 623-6260
Entity
Organization
Contact information
Practice address
109 E MAPLE ST, MASON, MI 48854-1655
(517) 676-4499
(517) 676-3221
Mailing address
109 E MAPLE ST, MASON, MI 48854-1655
(517) 676-4499
(517) 676-3221
Taxonomy
Speciality
Code
Description
License number
State
152W00000X
Optometrist
Primary
GL002568
MI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0C30191
BLUE CROSS BLUE SHIELD OF MICHIGAN
MI
05
—
945050168
—
MI
Enumeration date
03/11/2010
Last updated
12/21/2010
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