Individual
DR. LAURA LYNN KENYON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
O.D.
Contact information
Practice address
2112 EAST PARIS AVE SE, GRAND RAPIDS, MI 49546
(616) 949-8500
(616) 949-2878
Mailing address
2112 EAST PARIS AVE SE, GRAND RAPIDS, MI 49546
(616) 949-8500
(616) 949-2878
Taxonomy
Speciality
Code
Description
License number
State
152W00000X
Optometrist
06748TG
TX
152W00000X
Optometrist
Primary
4901004317
MI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
4892953
—
MI
Enumeration date
04/10/2006
Last updated
04/01/2021
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