Individual
ALICIA BULTSMA
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
OD
Contact information
Practice address
2908 DIVISION ST, SAINT JOSEPH, MI 49085-2437
(269) 983-3309
(269) 983-0846
Mailing address
905 S MAIN AVE, PLATTE, SD 57369-2129
Taxonomy
Speciality
Code
Description
License number
State
152W00000X
Optometrist
Primary
4901005482
MI
Other
Enumeration date
05/13/2022
Last updated
10/17/2023
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