Organization
COMPREHENSIVE EYE CARE PC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
RENEE LOBERT OD (PRESIDENT)
(616) 361-6612
Entity
Organization
Contact information
Practice address
2700 5 MILE RD NE, GRAND RAPIDS, MI 49525-1710
(616) 361-6612
Mailing address
2700 5 MILE RD NE, GRAND RAPIDS, MI 49525-1710
Taxonomy
Speciality
Code
Description
License number
State
152W00000X
Optometrist
Primary
4901003334
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
4259720001
ADMINISTAR FED B DME MAC
MI
01
—
900D166330
BCBSM
MI
01
—
MI 4010
OTHER
MI
Enumeration date
06/27/2007
Last updated
10/19/2015
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