| Lana Gruizenga, OD | |
|
133 E Michigan Ave, Paw Paw, MI 49079-1429 | |
| (269) 657-7288 | |
| (269) 655-9063 |
| Full Name | Lana Gruizenga |
|---|---|
| Gender | Female |
| Speciality | Optometrist |
| Location | 133 E Michigan Ave, Paw Paw, Michigan |
| Accepts Medicare Assignments | Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs. |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1518048214 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 152W00000X | Optometrist | 4901003341 (Michigan) | Primary |
| Provider Name | Hiemstra Optical Company |
|---|---|
| Provider Type | Part B Supplier - Clinic/group Practice |
| Provider Identifiers | NPI Number: 1841371556 PECOS PAC ID: 7618098062 Enrollment ID: O20120306000880 |
| Mailing Address | Practice Location Address |
|---|---|
| Lana Gruizenga, OD 133 E Michigan Ave, Paw Paw, MI 49079-1429 Ph: (269) 657-7288 | Lana Gruizenga, OD 133 E Michigan Ave, Paw Paw, MI 49079-1429 Ph: (269) 657-7288 |
Peter A Caroselli, OD Optometrist Medicare: Accepting Medicare Assignments Practice Location: 133 E Michigan Ave, Paw Paw, MI 49079 Phone: 269-657-7288 Fax: 269-655-9063 | |
David A Cleary, OD Optometrist Medicare: Not Enrolled in Medicare Practice Location: 133 E Michigan Ave, Paw Paw, MI 49079 Phone: 269-657-7288 Fax: 269-655-9063 | |
Phillip J Zwier, OD Optometrist Medicare: Medicare Enrolled Practice Location: 133 E Michigan Ave, Paw Paw, MI 49079 Phone: 269-657-7288 Fax: 269-655-9063 | |
Grant Morrison, OD Optometrist Medicare: Medicare Enrolled Practice Location: 133 E Michigan Ave, Paw Paw, MI 49079 Phone: 269-657-7288 Fax: 269-655-9063 |