Organization
SHORELINE OPTICAL, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
ANDREA LYNN PATRICK (ACCOUNT MANAGER)
(616) 588-6593
Entity
Organization
Contact information
Practice address
1401 W MAIN ST, SUITE 101, FREMONT, MI 49412-1486
(231) 739-9009
(231) 924-4604
Mailing address
1266 E SHERMAN BLVD, MUSKEGON, MI 49444-1847
(231) 739-9009
(231) 733-0566
Taxonomy
Speciality
Code
Description
License number
State
156FX1800X
Optician
—
—
332H00000X
Eyewear Supplier
Primary
—
—
Other
Enumeration date
11/29/2012
Last updated
05/22/2024
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