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Individual

AIMEE BRONSON

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
O.D.

Contact information

Practice address
6680 DIVISION AVE S, GRAND RAPIDS, MI 49548-7834
(616) 455-2525
(616) 455-9135
Mailing address
692 W RANDALL ST, COOPERSVILLE, MI 49404-1306
(616) 455-2525
(616) 455-9135

Taxonomy

Speciality
Code
Description
License number
State
152W00000X
Optometrist
Primary
4901003997
MI

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
2587297
MI
01
410043795
RAILROAD MEDICARE
MI
01
OD11398
BCBS CEC GROUP
Enumeration date
10/11/2006
Last updated
10/02/2018
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