Provider Demographics
NPI:1881303956
Name:GARTLAND FAMILY VISION
Entity type:Organization
Organization Name:GARTLAND FAMILY VISION
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OPTOMETRIST
Authorized Official - Prefix:
Authorized Official - First Name:LEANNE
Authorized Official - Middle Name:ALEXIS
Authorized Official - Last Name:GARTLAND
Authorized Official - Suffix:
Authorized Official - Credentials:OD
Authorized Official - Phone:906-241-7428
Mailing Address - Street 1:312 N LINCOLN RD
Mailing Address - Street 2:
Mailing Address - City:ESCANABA
Mailing Address - State:MI
Mailing Address - Zip Code:49829-1326
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:312 N LINCOLN RD
Practice Address - Street 2:
Practice Address - City:ESCANABA
Practice Address - State:MI
Practice Address - Zip Code:49829-1326
Practice Address - Country:US
Practice Address - Phone:906-798-0668
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2022-11-17
Last Update Date:2022-11-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes152W00000XEye and Vision Services ProvidersOptometristGroup - Single Specialty