Individual
MIKENZIE WOODS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
OD
Contact information
Practice address
1540 TRINITY PL, MISHAWAKA, IN 46545-5006
(574) 272-9000
Mailing address
50631 LAKESIDE DR, GRANGER, IN 46530-4932
(574) 383-8553
Taxonomy
Speciality
Code
Description
License number
State
152W00000X
Optometrist
Primary
18004669A
IN
Other
Enumeration date
06/03/2026
Last updated
06/03/2026
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