Provider Demographics
NPI:1518583673
Name:TOTTEN, JULIA (OD)
Entity Type:Individual
Prefix:DR
First Name:JULIA
Middle Name:
Last Name:TOTTEN
Suffix:
Gender:F
Credentials:OD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:17982 WILDWOOD SPRINGS PKWY
Mailing Address - Street 2:
Mailing Address - City:SPRING LAKE
Mailing Address - State:MI
Mailing Address - Zip Code:49456-9241
Mailing Address - Country:US
Mailing Address - Phone:231-557-6520
Mailing Address - Fax:
Practice Address - Street 1:951 SEMINOLE RD
Practice Address - Street 2:
Practice Address - City:NORTON SHORES
Practice Address - State:MI
Practice Address - Zip Code:49441-4341
Practice Address - Country:US
Practice Address - Phone:231-780-4700
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2020-06-24
Last Update Date:2020-06-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI4901005442152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152W00000XEye and Vision Services ProvidersOptometrist