| NPI | 1235510892 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | GREGORY CARMEN HAZEN Medical Director 989-249-1030 |
| Organization Subpart ? | No |
| Primary Taxonomy | 156FX1700X Technician/Technologist, Ocularist |
| Enumeration Date | 2015-06-09 |
| Last Update Date | 2016-02-24 |