| NPI | 1174726517 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JULIE A HANSON Owner Optometrist 231-832-3218 |
| Organization Subpart ? | No |
| Primary Taxonomy | 152W00000X Optometrist |
| Additional Taxonomies | 332H00000X Eyewear Supplier (Equipment, not the service) |
| Enumeration Date | 2007-06-05 |
| Last Update Date | 2008-08-29 |