Simon, Katie Lee
Simon, Katie Lee is an individual health care provider with primary practice located at 6483 S Westnedge Ave , Portage MI 49002-3542. She recently has only one registered license in Eye and Vision Services Providers / Optometrist, which is considered as her primary health care specialty. Simon, Katie Lee can be contacted via phone (269) 324-4242.Contact Information
Primary practice address
6483 S Westnedge Ave
Portage MI 49002-3542
Phone: (269) 324-4242
Fax: (269) 324-6145
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Eye and Vision Services Providers / Optometrist | 152W00000X | 4901004118 | Michigan |
Profile Details
| NPI number | 1366429581 |
|---|---|
| LBN Legal business name | Simon, Katie Lee |
| Credentials | Doctor of Optometry (OD) |
| Entity | Individual |
| Sole proprietor 1 | No |
| Enumeration date | Dec 29th, 2005 |
| Last updated | Mar 3rd, 2022 - about 4 years ago |
1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1366429581 | NPPES |
| Michigan | MEDICAID | 4551220 |
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