| NPI | 1295896900 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | CHRISTOPHER DAVID THEODOROFF Optometrist 586-573-0470 |
| Organization Subpart ? | No |
| Primary Taxonomy | 152W00000X Optometrist (Licence: MI 4901003333) |
| Enumeration Date | 2006-12-13 |
| Last Update Date | 2008-05-27 |