Individual
DR. ALICE MARIE BACAK
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
O.D.
Contact information
Practice address
1088 S BAILEY AVE, SUITE B, SOUTH HAVEN, MI 49090-9728
(269) 637-1442
(269) 637-3801
Mailing address
1088 S BAILEY AVE, SUITE B, SOUTH HAVEN, MI 49090-9728
(269) 637-1442
(269) 637-3801
Taxonomy
Speciality
Code
Description
License number
State
152W00000X
Optometrist
Primary
4901003231
MI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1994216
—
MI
Enumeration date
07/08/2005
Last updated
03/12/2008
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