Individual
LISA NGUYEN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
5838 METRO WAY SW, WYOMING, MI 49519-9619
(616) 249-5300
Mailing address
3060 DAYBREAK LN, HOLLAND, MI 49424-8589
Taxonomy
Speciality
Code
Description
License number
State
152W00000X
Optometrist
18004469A
IN
152W00000X
Optometrist
Primary
4901005645
MI
152W00000X
Optometrist
OPT5644
MA
Other
Enumeration date
08/29/2022
Last updated
04/03/2024
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