Provider Demographics
NPI:1720574031
Name:GOSLIN, LAUREN ASHLEE (OD)
Entity Type:Individual
Prefix:
First Name:LAUREN
Middle Name:ASHLEE
Last Name:GOSLIN
Suffix:
Gender:F
Credentials:OD
Other - Prefix:
Other - First Name:LAUREN
Other - Middle Name:ASHLEE
Other - Last Name:BARNES
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:409 W LUDINGTON AVE
Mailing Address - Street 2:
Mailing Address - City:LUDINGTON
Mailing Address - State:MI
Mailing Address - Zip Code:49431-2377
Mailing Address - Country:US
Mailing Address - Phone:231-843-4117
Mailing Address - Fax:231-843-7631
Practice Address - Street 1:409 W LUDINGTON AVE
Practice Address - Street 2:
Practice Address - City:LUDINGTON
Practice Address - State:MI
Practice Address - Zip Code:49431-2377
Practice Address - Country:US
Practice Address - Phone:231-843-4117
Practice Address - Fax:231-843-7631
Is Sole Proprietor?:No
Enumeration Date:2018-07-10
Last Update Date:2023-08-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AK134226152W00000X
MI4901005608152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152W00000XEye and Vision Services ProvidersOptometrist