| NPI | 1205870532 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | REGINALD DEAN GRANDISON Optometrist 248-327-6249 |
| Organization Subpart ? | No |
| Primary Taxonomy | 152W00000X Optometrist (Licence: MI 4901003700) |
| Enumeration Date | 2006-06-16 |
| Last Update Date | 2012-11-16 |