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1184615742
PHILLIP A KOHANOV
FORT GRATIOT, MI
NPI
1184615742
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Entity Type
Individual
Gender
Male
Sole Proprietor ?
Yes
Primary Taxonomy
152W00000X Optometrist
(Licence: MI 4901003217)
Enumeration Date
2005-11-02
Last Update Date
2012-06-06
Business Address
DR. PHILLIP A KOHANOV O.D.
3833 24TH AVE
FORT GRATIOT, MI 48059-4100
Phone number: 810-985-5600
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Mailing Address
DR. PHILLIP A KOHANOV O.D.
3833 24TH AVE
FORT GRATIOT, MI 48059-4100
Phone number: 810-985-5600
Copy
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