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Individual

FERRIS R STANDIFORD

Active
Sole proprietor

Provider details

NPI number
Gender
Man
Credential
O.D.

Contact information

Practice address
3412 W CENTRE AVE, PORTAGE, MI 49024-4624
(269) 329-5870
(269) 329-5865
Mailing address
3412 W CENTRE AVE, PORTAGE, MI 49024-4624
(269) 329-5870
(269) 329-5865

Taxonomy

Speciality
Code
Description
License number
State
152W00000X
Optometrist
Primary
4901003034
MI

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
4073524
MI
Enumeration date
04/11/2006
Last updated
07/08/2007
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