Individual
DR. JUSTIN CHAMPION ULLREY
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
O.D.
Contact information
Practice address
25 N MAIN ST, ROCKFORD, MI 49341-1281
(616) 866-3077
Mailing address
10502 SHANER AVE NE, ROCKFORD, MI 49341-8461
Taxonomy
Speciality
Code
Description
License number
State
152W00000X
Optometrist
Primary
4901005240
MI
Other
Enumeration date
06/05/2019
Last updated
06/05/2019
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