Most Relevant Information
Provider Data
| NPI Number: | 1003390113 |
| Provider Name: | LAUREN YOON BALTIERRA OD |
| Entity Type: | Individual |
| Taxonomy Code: | 152W00000X |
| Specialty: | Optometrist |
| License Number: | 4901005161 |
Most Important Dates
| Enumeration Date: | 09/25/2018 |
| Last Updated: | 03/29/2023 |
Provider Practice Location
22750 ALLEN RD
WOODHAVEN
MI
481832246
Practice Location Phone/Fax
| Phone: | 7346764300 |
| Fax: | 7346765348 |
Provider Mailing Location
1950 OLD GALLOWS RD STE 520
VIENNA
VA
221823970
Provider Mailing Phone/Fax
| Phone: | 7038478899 |
| Fax: | 5712236780 |