Organization
PROFESSIONAL EYECARE OF WEST MICHIGAN LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. TROY LEBARON O.D. (MEMBER)
(616) 334-9255
Entity
Organization
Contact information
Practice address
6750 KALAMAZOO AVE SE, SUITE C, GRAND RAPIDS, MI 49508-7897
(616) 656-0505
(616) 682-5163
Mailing address
6750 KALAMAZOO AVE SE, SUITE C, GRAND RAPIDS, MI 49508-7897
(616) 656-0505
(616) 682-5163
Taxonomy
Speciality
Code
Description
License number
State
152W00000X
Optometrist
Primary
4901004426
MI
Other
Enumeration date
10/01/2009
Last updated
06/08/2010
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