ProviderBusinessMailingAddressFaxNumber = '6163950077'
NPI
LastName
FirstName
MidName
Organization
Mailing Address
City
State
Zip
1760668016
LAKESHORE EYECARE CENTER P C
11971 JAMES ST
HOLLAND
MI
494249610
1477928612
BALA
JAMIE
2657 120TH AVE
HOLLAND
MI
494248692
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