| NPI | 1063709137 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | GAIL A. ELIAS Director Of Finance 248-577-3624 |
| Organization Subpart ? | No |
| Primary Taxonomy | 152W00000X Optometrist |
| Additional Taxonomies | 332H00000X Eyewear Supplier |
| Enumeration Date | 2011-07-08 |
| Last Update Date | 2020-01-23 |