Organization
COOPERSVILLE VISION CENTER PC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DAWN K WALT OD (OWNER)
(616) 837-6847
Entity
Organization
Contact information
Practice address
692 W RANDALL ST, COOPERSVILLE, MI 49404-1306
(616) 837-6847
(616) 837-9338
Mailing address
692 W RANDALL ST, COOPERSVILLE, MI 49404-1306
(616) 837-6847
(616) 837-9338
Taxonomy
Speciality
Code
Description
License number
State
152W00000X
Optometrist
Primary
4901002956
MI
Other
Enumeration date
02/09/2007
Last updated
04/29/2008
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