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Individual

DR. ANNAH NYBLAD FOX

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
O.D.

Contact information

Practice address
100 CHERRY ST SE, GRAND RAPIDS, MI 49503-4526
(616) 965-8200
(616) 940-5366
Mailing address
100 CHERRY ST SE, GRAND RAPIDS, MI 49503-4526
(616) 965-8200
(616) 940-5366

Taxonomy

Speciality
Code
Description
License number
State
152W00000X
Optometrist
Primary
4901004794
MI
152W00000X
Optometrist
OPT929
ME

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
1578841094
NPI
Enumeration date
08/01/2011
Last updated
08/12/2013
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