NPI | 1245371285 |
---|---|
Entity Type | Organization |
Authorized Contact | KEVIN M FLYNN Manager 269-629-2020 |
Organization Subpart ? | No |
Primary Taxonomy | 152W00000X Optometrist (Licence: MI 4901003819) |
Additional Taxonomies | 152W00000X Optometrist (Licence: MI 4901003815) |
Enumeration Date | 2007-02-11 |
Last Update Date | 2008-07-30 |