Individual
DR. JOHN MICHAEL LARGE
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
O.D.
Contact information
Practice address
5959 LAWNDALE ST, LUDINGTON, MI 49431-2921
(231) 845-6261
(231) 843-9171
Mailing address
5959 LAWNDALE ST, LUDINGTON, MI 49431-2921
(231) 845-6261
(231) 843-9171
Taxonomy
Speciality
Code
Description
License number
State
152W00000X
Optometrist
Primary
4901004921
MI
Other
Enumeration date
07/23/2015
Last updated
07/23/2015
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