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Individual

JAIMIE LYNN CHURCH

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
O.D.

Contact information

Practice address
1860 PIPESTONE RD, BENTON HARBOR, MI 49022-2304
(616) 927-5868
(616) 934-9485
Mailing address
2583 LAKE PINE DR, #13, SAINT JOSEPH, MI 49085-8200
(616) 240-1301

Taxonomy

Speciality
Code
Description
License number
State
152W00000X
Optometrist
Primary
4901004309
MI

Other

Enumeration date
01/02/2007
Last updated
07/08/2007
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