Individual
DR. SCOTT RICHARD ECENBARGER
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
O.D.
Contact information
Practice address
5751 BYRON CENTER AVE SW, SUITE V, WYOMING, MI 49519-9621
(616) 532-2020
(616) 532-2022
Mailing address
5751 BYRON CENTER AVE SW, SUITE V, WYOMING, MI 49519-9621
(616) 532-2020
(616) 532-2022
Taxonomy
Speciality
Code
Description
License number
State
152W00000X
Optometrist
Primary
4901004003
MI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
94-4712563
—
WI
Enumeration date
06/09/2006
Last updated
05/19/2010
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