Individual
MARIA E SICCO
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
OD
Contact information
Practice address
100 CHERRY ST SE, GRAND RAPIDS, MI 49503-4526
(616) 965-8200
Mailing address
100 CHERRY ST SE, GRAND RAPIDS, MI 49503-4526
(616) 965-8200
Taxonomy
Speciality
Code
Description
License number
State
152W00000X
Optometrist
Primary
4901005385
MI
Other
Enumeration date
06/18/2019
Last updated
06/18/2019
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