| NPI | 1316900608 |
|---|---|
| Doing Business As | D.O.C CHESTERFIELD VILLAGE SQUARE |
| Entity Type | Organization |
| Authorized Contact | DAVID BRYAN TAYLOR President 586-598-3935 |
| Organization Subpart ? | No |
| Primary Taxonomy | 152W00000X Optometrist (Licence: MI 4901003653) |
| Additional Taxonomies | 152W00000X Optometrist (Licence: MI 4901003352) |
| 156FX1800X Technician/Technologist, Optician | |
| Enumeration Date | 2006-04-09 |
| Last Update Date | 2020-08-22 |