Individual
LAUREN EWALD
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
12606 HOLLY RD, GRAND BLANC, MI 48439-1892
(810) 694-3652
Mailing address
15500 SILVER PKWY APT 202, FENTON, MI 48430-3475
Taxonomy
Speciality
Code
Description
License number
State
152W00000X
Optometrist
Primary
4901005709
MI
Other
Enumeration date
06/09/2023
Last updated
06/09/2023
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