| NPI | 1013122639 |
|---|---|
| Doing Business As | FENTON VISION CENTER |
| Entity Type | Organization |
| Authorized Contact | JUAN ALVARADO Optometrist 810-629-3070 |
| Organization Subpart ? | No |
| Primary Taxonomy | 152W00000X Optometrist (Licence: MI 4901003993) |
| Additional Taxonomies | 152W00000X Optometrist (Licence: MI 4901002996) |
| Enumeration Date | 2007-05-14 |
| Last Update Date | 2020-08-22 |