| NPI | 1114103140 |
|---|---|
| Former Legal Business Name | KORINNE SWAIN, O.D. |
| Entity Type | Organization |
| Authorized Contact | KORINNE MARIE SWAIN Owner 231-744-3573 |
| Organization Subpart ? | No |
| Primary Taxonomy | 305S00000X Point of Service (Licence: MI 49010003090) |
| Additional Taxonomies | 332B00000X Durable Medical Equipment & Medical Supplies (Licence: MI 4901003090) |
| Enumeration Date | 2008-01-22 |
| Last Update Date | 2014-03-12 |