| NPI | 1427322429 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | REANNAN MICHELLE MCDONALD Manager 248-858-2535 |
| Organization Subpart ? | No |
| Primary Taxonomy | 152W00000X Optometrist (Licence: MI 4901002371) |
| Enumeration Date | 2012-03-08 |
| Last Update Date | 2014-02-05 |