Individual
JOHN S GRAVES
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
O.D. PC
Contact information
Practice address
105 N GROVE, STANDISH, MI 48658-0576
(989) 846-4197
(989) 846-4989
Mailing address
105 N GROVE, 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
—
900Z600100
BLUE CROSS BLUE SHIELD OF MICHIGAN
MI
Enumeration date
01/11/2006
Last updated
03/22/2023
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