Organization
SOUTH KENT VISION CENTER PC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. ROBERT ARTHUR HOHENDORF O.D. (PRESIDENT/OWNER)
(616) 534-4953
Entity
Organization
Contact information
Practice address
4467 BYRON CENTER AVE SW, WYOMING, MI 49519-4808
(616) 534-4953
Mailing address
4467 BYRON CENTER AVE SW, WYOMING, MI 49519-4808
(616) 534-4953
Taxonomy
Speciality
Code
Description
License number
State
152W00000X
Optometrist
Primary
4901002522
MI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
943216794
—
MI
01
—
OD16559
BLUE CROSS BLUE SHIELD
MI
Enumeration date
01/28/2008
Last updated
05/30/2013
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