Organization
LASCASSAS EYE CARE PLLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. MARY GRACE MCCUBBIN OD (OWNER)
(616) 809-2416
Entity
Organization
Contact information
Practice address
4704 LASCASSAS PIKE, LASCASSAS, TN 37085-4511
(615) 809-2416
(615) 962-7231
Mailing address
4704 LASCASSAS PIKE, LASCASSAS, TN 37085-4511
(615) 809-2416
(615) 962-7231
Taxonomy
Speciality
Code
Description
License number
State
152W00000X
Optometrist
Primary
2902
TN
Other
Enumeration date
05/26/2011
Last updated
06/17/2011
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