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Individual

JOHN G FORD

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
OD

Contact information

Practice address
4070 LAKE DR SE, SUITE 101, GRAND RAPIDS, MI 49546-8294
(616) 949-8500
(616) 949-2878
Mailing address
4070 LAKE DR SE, SUITE 101, GRAND RAPIDS, MI 49546-8294
(616) 949-8500
(616) 949-2878

Taxonomy

Speciality
Code
Description
License number
State
152W00000X
Optometrist
Primary
4901003328
MI

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
3484937
MI
Enumeration date
12/21/2005
Last updated
07/29/2010
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