| NPI | 1073125076 |
|---|---|
| Doing Business As | LAKESHORE EYE CONSULTANTS |
| Entity Type | Organization |
| Authorized Contact | MARC BOOTH Owner/Physician 765-414-3876 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207W00000X Ophthalmology |
| Enumeration Date | 2020-08-20 |
| Last Update Date | 2020-08-20 |