Data from the NPPES registry. May not reflect recent changes — verify at nppes.cms.hhs.gov.
LIESL A BLACK, O.D.
ActiveLIESL A BLACK, O.D. is a Optometrist healthcare provider located in CASCO, Michigan. NPI 1912529512 is currently active in the NPPES registry. Verify at CMS.
Optometrist · CASCO, MI
Registration Details
- NPI Number
- 1912529512
- Provider Type
- Individual
- Gender
- Female
- NPI Issued
- May 18, 2020 (6.2228973265908 yrs)
- Last Updated
- May 28, 2024
- License
-
4901005440 (MI)
Practice Information
- Address
-
3443 COUNTY LINE RDCASCO, MI, 480641000Browse MI providers · Browse ZIP 48064
- Phone
- 5867278000
- Fax
- 5867278004
- Primary Specialty
-
Optometrist
152W00000X
Other Optometrist Providers in CASCO, MI
| Name | Credential | NPI |
|---|---|---|
| MS. LINDSEY ELLICOTT-GASTA | O.D. | 1174908057 |
Data sourced from the NPPES National Provider Identifier registry. This information is for informational purposes only and is not a substitute for verifying credentials with the appropriate licensing authority. For official verification, use the NPPES NPI Registry or the relevant state medical board.