Individual
COURTNEY WEN YING FAN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
OD
Contact information
Practice address
1793 S CEDAR ST, IMLAY CITY, MI 48444-1342
(810) 721-9411
(810) 721-9512
Mailing address
118 CASS AVE, MOUNT CLEMENS, MI 48043-2204
(586) 468-7370
Taxonomy
Speciality
Code
Description
License number
State
152W00000X
Optometrist
Primary
4901005375
MI
Other
Enumeration date
10/12/2021
Last updated
04/10/2025
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