Individual
DR. LORI F GLASS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
O.D.
Contact information
Practice address
2107 S. 11TH ST, NILES, MI 49120
(269) 683-0878
(269) 683-0878
Mailing address
2107 S. 11TH ST, NILES, MI 49120
(269) 683-0878
(269) 683-0878
Taxonomy
Speciality
Code
Description
License number
State
152W00000X
Optometrist
Primary
4901003558
MI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
PHARM REG5330000174
4901003558
MI
Enumeration date
10/16/2006
Last updated
12/13/2016
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