Individual
DR. STACEY KAY WUSTMAN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
OD
Contact information
Practice address
3232 CENTRAL BLVD, HUDSONVILLE, MI 49426-1439
(616) 669-2530
Mailing address
3524 RIVER RUN ST SW, WYOMING, MI 49418-8818
(616) 403-2192
Taxonomy
Speciality
Code
Description
License number
State
152W00000X
Optometrist
Primary
4901005070
MI
Other
Enumeration date
07/03/2017
Last updated
07/03/2017
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