Provider Demographics
NPI:1154550325
Name:ROUTHIER, JANELLE (OD)
Entity type:Individual
Prefix:
First Name:JANELLE
Middle Name:
Last Name:ROUTHIER
Suffix:
Gender:F
Credentials:OD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7111 DIXIE HWY #152
Mailing Address - Street 2:
Mailing Address - City:CLARKSTON
Mailing Address - State:MI
Mailing Address - Zip Code:48346
Mailing Address - Country:US
Mailing Address - Phone:248-620-1100
Mailing Address - Fax:248-620-1196
Practice Address - Street 1:1159 N US HIGHWAY 31
Practice Address - Street 2:
Practice Address - City:PETOSKEY
Practice Address - State:MI
Practice Address - Zip Code:49770-9305
Practice Address - Country:US
Practice Address - Phone:231-347-6054
Practice Address - Fax:231-347-0969
Is Sole Proprietor?:No
Enumeration Date:2009-07-09
Last Update Date:2009-07-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI4901004499152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152W00000XEye and Vision Services ProvidersOptometrist