Provider Demographics
NPI:1558669473
Name:VONHATTEN, KATHY MARIE (CERTIFIED OPTICIAN)
Entity Type:Individual
Prefix:
First Name:KATHY
Middle Name:MARIE
Last Name:VONHATTEN
Suffix:
Gender:F
Credentials:CERTIFIED OPTICIAN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:8815 SPINNAKER WAY
Mailing Address - Street 2:APT B4
Mailing Address - City:YPSILANTI
Mailing Address - State:MI
Mailing Address - Zip Code:48197
Mailing Address - Country:US
Mailing Address - Phone:321-225-2238
Mailing Address - Fax:
Practice Address - Street 1:100 BRIARWOOD CIR
Practice Address - Street 2:
Practice Address - City:ANN ARBOR
Practice Address - State:MI
Practice Address - Zip Code:48108-1602
Practice Address - Country:US
Practice Address - Phone:321-225-2238
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2011-03-01
Last Update Date:2011-03-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes156FX1800XEye and Vision Services ProvidersTechnician/TechnologistOptician