Organization
PORTAGE FAMILY VISION CARE, PC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
KATIE SIMON O.D. (PRESIDENT/OWNER)
(269) 324-4242
Entity
Organization
Contact information
Practice address
6483 S WESTNEDGE AVE, PORTAGE, MI 49002-3542
(269) 324-4242
(269) 324-6145
Mailing address
6483 S WESTNEDGE AVE, PORTAGE, MI 49002-3542
(269) 324-4242
(269) 324-6145
Taxonomy
Speciality
Code
Description
License number
State
152W00000X
Optometrist
Primary
4901004118
MI
Other
Enumeration date
02/13/2013
Last updated
02/13/2013
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