| NPI | 1225477318 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | PATRICIA PARKS Billing Manager 517-231-4086 |
| Organization Subpart ? | No |
| Primary Taxonomy | 152W00000X Optometrist |
| Additional Taxonomies | 261QH0100X Clinic/Center Health Service |
| Enumeration Date | 2013-06-21 |
| Last Update Date | 2024-12-09 |