Individual
MARY LEANN BOOMER
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
O.D.
Contact information
Practice address
929 BUSINESS PARK DR, TRAVERSE CITY, MI 49686-8683
(231) 947-6246
Mailing address
929 BUSINESS PARK DR, TRAVERSE CITY, MI 49686-8683
(231) 947-6246
Taxonomy
Speciality
Code
Description
License number
State
152W00000X
Optometrist
Primary
4901005448
MI
Other
Enumeration date
05/17/2020
Last updated
04/03/2024
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