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1215025572
LEIGH SHORES
FORT GRATIOT, MI
NPI
1215025572
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Entity Type
Individual
Gender
Male
Sole Proprietor ?
No
Primary Taxonomy
152W00000X Optometrist
(Licence: MI 4901003150)
Enumeration Date
2006-10-11
Last Update Date
2007-07-08
Business Address
LEIGH SHORES O.D.
3923 PINE GROVE ROAD
FORT GRATIOT, MI 48059-4251
Phone number: 810-985-3333
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Mailing Address
LEIGH SHORES O.D.
3923 PINE GROVE ROAD
FORT GRATIOT, MI 48059-4251
Phone number: 810-985-3333
Copy
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