Individual
DR. JON R WIERINGA
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
O.D.
Contact information
Practice address
2112 EAST PARIS AVE SE, GRAND RAPIDS, MI 49546
(616) 949-8500
(616) 949-2878
Mailing address
2112 EAST PARIS AVE SE, GRAND RAPIDS, MI 49546
(616) 949-8500
(616) 949-2878
Taxonomy
Speciality
Code
Description
License number
State
152W00000X
Optometrist
Primary
251
AK
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1518977230
—
MI
01
—
900H115190
BCBS MICHIGAN
MI
Enumeration date
08/08/2006
Last updated
12/15/2016
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