Individual
LACEE JO CRIPE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
5612 BULLARD RD, FENTON, MI 48430-9408
(574) 276-5677
Mailing address
5612 BULLARD RD, FENTON, MI 48430-9408
Taxonomy
Speciality
Code
Description
License number
State
156FX1800X
Optician
Primary
—
—
332H00000X
Eyewear Supplier
—
—
Other
Enumeration date
12/18/2024
Last updated
12/18/2024
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