Individual
STEPHANIE MAE PARKER
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
OD
Contact information
Practice address
4281 24TH AVE, FORT GRATIOT, MI 48059-3997
(810) 385-4000
Mailing address
4948 POTOMAC SQUARE PL UNIT 2, INDIANAPOLIS, IN 46268-5802
(810) 338-9254
Taxonomy
Speciality
Code
Description
License number
State
152W00000X
Optometrist
Primary
4901005548
MI
Other
Enumeration date
05/29/2021
Last updated
05/29/2021
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