Organization
JANSMA FAMILY EYE CARE INC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. RANDALL H JANSMA O.D. (DOCTOR)
(616) 261-3939
Entity
Organization
Contact information
Practice address
5491 DIVISION AVE S, GRAND RAPIDS, MI 49548-5720
(616) 261-3939
(616) 261-3940
Mailing address
5491 DIVISION AVE S, GRAND RAPIDS, MI 49548-5720
(616) 261-3939
(616) 261-3940
Taxonomy
Speciality
Code
Description
License number
State
152W00000X
Optometrist
Primary
4901003272
MI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
900D16699
BLUE CROSS BLUE SHIELD OF MI
MI
Enumeration date
07/08/2010
Last updated
02/01/2011
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