Organization
ALLENDALE FAMILY VISION LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. NICHOLAS VIJAY LILLIE O.D. (PRESIDENT)
(616) 895-2020
Entity
Organization
Contact information
Practice address
6101 LAKE MICHIGAN DR, ALLENDALE, MI 49401-9215
(616) 895-2020
(616) 895-2060
Mailing address
6101 LAKE MICHIGAN DR, STE B700, ALLENDALE, MI 49401-9215
(616) 895-2020
(616) 895-2060
Taxonomy
Speciality
Code
Description
License number
State
152W00000X
Optometrist
Primary
4901004659
MI
Other
Enumeration date
07/20/2011
Last updated
05/02/2013
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