Provider Demographics
NPI:1265481683
Name:ZEELAND VISION SERVICES PC
Entity Type:Organization
Organization Name:ZEELAND VISION SERVICES PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:THOMAS
Authorized Official - Middle Name:
Authorized Official - Last Name:BOCK
Authorized Official - Suffix:
Authorized Official - Credentials:OD
Authorized Official - Phone:616-772-9149
Mailing Address - Street 1:300 S STATE ST
Mailing Address - Street 2:SUITE #15
Mailing Address - City:ZEELAND
Mailing Address - State:MI
Mailing Address - Zip Code:49464-1678
Mailing Address - Country:US
Mailing Address - Phone:616-772-9149
Mailing Address - Fax:616-772-2906
Practice Address - Street 1:300 S STATE ST
Practice Address - Street 2:SUITE #15
Practice Address - City:ZEELAND
Practice Address - State:MI
Practice Address - Zip Code:49464-1678
Practice Address - Country:US
Practice Address - Phone:616-772-9149
Practice Address - Fax:616-772-2906
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-05-10
Last Update Date:2022-05-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes152W00000XEye and Vision Services ProvidersOptometristGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
MI0G07612Medicare ID - Type Unspecified
MI0603840001Medicare NSC
MICM9616Medicare PIN