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Organization

ANDERSON EYE CARE, LLC

Active
Organization subpart
No

Provider details

NPI number
Authorized official
DR. GARY A ANDERSON O.D. (OWNER)
(616) 459-7380
Entity
Organization

Contact information

Practice address
55 CAMPAU AVE NW, RIVERFRONT PLAZA BLDG-SUITE #10, GRAND RAPIDS, MI 49503-2642
(616) 459-7380
(616) 459-5752
Mailing address
55 CAMPAU AVE NW, RIVERFRONT PLAZA BLDG-SUITE #10, GRAND RAPIDS, MI 49503-2642
(616) 459-7380
(616) 459-5752

Taxonomy

Speciality
Code
Description
License number
State
152W00000X
Optometrist
Primary

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
900D120690
BLUE CROSS BLUE SHIELD
MI
Enumeration date
02/12/2008
Last updated
02/11/2010
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