Provider Demographics
NPI:1730377573
Name:GELFIUS, STEPHANIE LYNN (OD)
Entity type:Individual
Prefix:DR
First Name:STEPHANIE
Middle Name:LYNN
Last Name:GELFIUS
Suffix:
Gender:F
Credentials:OD
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Mailing Address - Street 1:2121 HUDSON AVE
Mailing Address - Street 2:SUITE 105
Mailing Address - City:KALAMAZOO
Mailing Address - State:MI
Mailing Address - Zip Code:49008-2379
Mailing Address - Country:US
Mailing Address - Phone:269-345-2916
Mailing Address - Fax:269-345-5335
Practice Address - Street 1:2121 HUDSON AVE
Practice Address - Street 2:SUITE 105
Practice Address - City:KALAMAZOO
Practice Address - State:MI
Practice Address - Zip Code:49008-2379
Practice Address - Country:US
Practice Address - Phone:269-345-2916
Practice Address - Fax:269-345-5335
Is Sole Proprietor?:No
Enumeration Date:2007-10-05
Last Update Date:2007-10-05
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
MI4901003752152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152W00000XEye and Vision Services ProvidersOptometrist