Vance, John Randall
Vance, John Randall is an individual health care provider with primary practice located at 1310 Cramer Circle Pennock 506, Big Rapids MI 49307-2738. He recently has only one registered license in Eye and Vision Services Providers / Optometrist, which is considered as his primary health care specialty. Vance, John Randall can be contacted via phone (231) 591-2222.Contact Information
Primary practice address
1310 Cramer Circle Pennock 506
Big Rapids MI 49307-2738
Phone: (231) 591-2222
Fax: (231) 591-3991
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Eye and Vision Services Providers / Optometrist | 152W00000X | 4901002609 | Michigan |
Profile Details
| NPI number | 1982625604 |
|---|---|
| LBN Legal business name | Vance, John Randall |
| Credentials | Doctor of Optometry (OD) |
| Entity | Individual |
| Sole proprietor 1 | No |
| Enumeration date | Jul 21st, 2006 |
| Last updated | Jul 8th, 2007 - about 19 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 | 1982625604 | NPPES |
| Michigan | Other | 0784610001013 | ADMINISTAR |
| Michigan | MEDICAID | 5095203 | ADMINISTAR |
| Michigan | Other | JV002609 | ADMINISTAR |
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