Provider Demographics
NPI:1447575253
Name:ALICE HANES OD PLLC
Entity Type:Organization
Organization Name:ALICE HANES OD PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:ALICE
Authorized Official - Middle Name:
Authorized Official - Last Name:HANES
Authorized Official - Suffix:
Authorized Official - Credentials:OD
Authorized Official - Phone:269-857-2864
Mailing Address - Street 1:3482 PALMER DR
Mailing Address - Street 2:
Mailing Address - City:SAUGATUCK
Mailing Address - State:MI
Mailing Address - Zip Code:49453-9460
Mailing Address - Country:US
Mailing Address - Phone:269-857-2864
Mailing Address - Fax:
Practice Address - Street 1:412 OAKS XING
Practice Address - Street 2:
Practice Address - City:PLAINWELL
Practice Address - State:MI
Practice Address - Zip Code:49080-1900
Practice Address - Country:US
Practice Address - Phone:269-685-6021
Practice Address - Fax:269-685-6049
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2010-04-05
Last Update Date:2010-12-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes152W00000XEye and Vision Services ProvidersOptometristGroup - Single Specialty