| NPI | 1164518106 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | DAVID GORDON VANOTTEREN President 734-649-4978 |
| Organization Subpart ? | No |
| Primary Taxonomy | 152W00000X Optometrist (Licence: MI 4901003594) |
| Enumeration Date | 2006-10-05 |
| Last Update Date | 2018-02-23 |