Organization
JOHN S GRAVES OD PC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. JOHN S GRAVES OD (OWNER)
(989) 846-4197
Entity
Organization
Contact information
Practice address
105 N GROVE ST, STANDISH, MI 48658-2508
(989) 846-4197
(989) 846-4989
Mailing address
PO BOX 576, STANDISH, MI 48658-0576
(989) 846-4197
(989) 846-4989
Taxonomy
Speciality
Code
Description
License number
State
152W00000X
Optometrist
Primary
4901003143
MI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
900Z60027
BCBS
MI
Enumeration date
03/08/2016
Last updated
01/05/2017
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