Organization
WEST MICHIGAN CONTACT LENS SPECIALISTS PLLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. ADELINE R BAUER OD (OWNER OPTOMETRIST)
(989) 906-7786
Entity
Organization
Contact information
Practice address
4130 BRETON RD SE STE A, KENTWOOD, MI 49512-3808
(616) 341-1713
Mailing address
7719 DREAM ISLE DR NE, BELDING, MI 48809-9370
(989) 906-7786
Taxonomy
Speciality
Code
Description
License number
State
152W00000X
Optometrist
Primary
—
—
152WC0802X
Corneal and Contact Management Optometrist
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
4901004841
OPTOMETRY LICENSE NUMBER
MI
Enumeration date
09/21/2022
Last updated
11/23/2022
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