| NPI | 1174637565 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | C STEVEN KOCKS Manager 989-792-8686 |
| Organization Subpart ? | No |
| Primary Taxonomy | 152W00000X Optometrist |
| Additional Taxonomies | 332B00000X Durable Medical Equipment & Medical Supplies |
| 332H00000X Eyewear Supplier (Equipment, not the service) | |
| 152WC0802X Optometrist, Corneal and Contact Management | |
| 152WP0200X Optometrist, Pediatrics | |
| 152WS0006X Optometrist, Sports Vision | |
| 152WV0400X Optometrist, Vision Therapy | |
| 156FX1800X Technician/Technologist, Optician | |
| 156FC0800X Technician/Technologist, Contact Lens | |
| Enumeration Date | 2006-08-19 |
| Last Update Date | 2013-12-03 |