Individual
MICHAELLA MARIE FORD
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
OD
Contact information
Practice address
3241 S MICHIGAN AVE STE 1, CHICAGO, IL 60616-3878
(312) 949-7119
(312) 949-7617
Mailing address
4499 TOWN CENTER PKWY, FLINT, MI 48532-3425
(810) 691-2450
Taxonomy
Speciality
Code
Description
License number
State
152W00000X
Optometrist
046011769
IL
152W00000X
Optometrist
Primary
4901005759
MI
Other
Enumeration date
07/06/2023
Last updated
07/25/2024
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