Individual
CYNTHIA GENEVA
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
OD
Contact information
Practice address
4070 LAKE DR SE, SUITE 101, GRAND RAPIDS, MI 49546-8294
(616) 949-8500
(616) 949-2878
Mailing address
4070 LAKE DR SE, STE 101, GRAND RAPIDS, MI 49546-8294
(616) 949-8500
(616) 949-2878
Taxonomy
Speciality
Code
Description
License number
State
152W00000X
Optometrist
Primary
4901004836
MI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1871510859
—
MI
01
—
900E476020
BLUE CROSS
—
Enumeration date
07/23/2014
Last updated
07/11/2016
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