Individual
DR. ANGELO CARMELO BENVENUTO JR.
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
O.D.
Contact information
Practice address
3579 ALPINE AVE NW, GRAND RAPIDS, MI 49544-1635
(616) 432-3591
Mailing address
3579 ALPINE AVE NW, GRAND RAPIDS, MI 49544-1635
(616) 432-3591
Taxonomy
Speciality
Code
Description
License number
State
152W00000X
Optometrist
Primary
4901004785
MI
Other
Enumeration date
07/03/2013
Last updated
10/11/2013
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