Individual
LILLIAN THORP KALACZINSKI
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
O.D.
Contact information
Practice address
1124 S STATE ST, BIG RAPIDS, MI 49307-2256
(231) 591-2189
Mailing address
7421 TREELINE DR SE, GRAND RAPIDS, MI 49546-7465
(616) 970-4630
Taxonomy
Speciality
Code
Description
License number
State
152W00000X
Optometrist
Primary
4901003922
MI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
4758580
—
MI
Enumeration date
11/02/2006
Last updated
01/23/2024
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