Organization
ADA VISION CENTER PLLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. THOMAS P. REYBURN O.D. (OWNER SINCE 1977)
(616) 676-1283
Entity
Organization
Contact information
Practice address
596 ADA DR SE, ADA, MI 49301-8465
(616) 676-1283
(616) 676-9133
Mailing address
596 ADA DR SE, ADA, MI 49301-8465
(616) 676-1283
(616) 676-9133
Taxonomy
Speciality
Code
Description
License number
State
152W00000X
Optometrist
Primary
4901002630
MI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
4140369
—
MI
Enumeration date
07/17/2006
Last updated
07/14/2023
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