| NPI | 1285102368 | 
|---|---|
| Entity Type | Organization | 
| Authorized Contact | JILL FRESHNEY Professional Services Manager 586-464-1479  | 
| Organization Subpart ? | No | 
| Primary Taxonomy | 152W00000X Optometrist | 
| Additional Taxonomies | 332H00000X Eyewear Supplier (Equipment, not the service) | 
| Enumeration Date | 2018-11-07 | 
| Last Update Date | 2023-06-28 |