Organization
FREDRIC C DEVRIES OD PC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. FREDRIC CARL DEVRIES O.D., F.A.A.O. (PRESIDENT)
(616) 538-0150
Entity
Organization
Contact information
Practice address
3050 IVANREST AVE SW, GRANDVILLE, MI 49418-1400
(616) 538-0150
(616) 538-3954
Mailing address
2711 BYRON STATION DR SW, BYRON CENTER, MI 49315-9458
(616) 583-0404
(616) 583-0405
Taxonomy
Speciality
Code
Description
License number
State
152W00000X
Optometrist
Primary
4901002219
MI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0D16540
PRIORITY HEALTH
MI
05
—
0D16540
—
MI
Enumeration date
10/13/2006
Last updated
11/07/2007
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