| NPI | 1265426514 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | DEANNE L MUSSER Billing Manager 231-932-4336 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207W00000X Ophthalmology |
| Additional Taxonomies | 152W00000X Optometrist |
| Enumeration Date | 2005-09-01 |
| Last Update Date | 2024-04-03 |