Organization
SWAN OPTOMETRY SERVICES, PC
Active
Other names
In Focus Eyecare of Rockford
Organization subpart
No
Provider details
NPI number
Authorized official
MARK SWAN OD, MED (OWNER)
(616) 866-3077
Entity
Organization
Contact information
Practice address
25 N MAIN ST, ROCKFORD, MI 49341-1281
(616) 866-3077
(616) 866-4408
Mailing address
25 N MAIN ST, ROCKFORD, MI 49341-1281
(616) 866-3077
(616) 866-4408
Taxonomy
Speciality
Code
Description
License number
State
152W00000X
Optometrist
Primary
4901003186
MI
152WP0200X
Pediatric Optometrist
4901003186
MI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
4401840
—
MI
01
—
900006367
PRIORITY HEALTH
MI
01
—
999998001
VSP
MI
01
—
M5003186
BLUE CROSS
MI
Enumeration date
10/15/2010
Last updated
09/09/2016
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