| NPI | 1457914335 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | LETICIA MOTA Owner O PT Ician 313-551-0707 |
| Organization Subpart ? | No |
| Primary Taxonomy | 152W00000X Optometrist |
| Additional Taxonomies | 156FX1100X Technician/Technologist, Ophthalmic |
| Enumeration Date | 2019-04-17 |
| Last Update Date | 2022-07-08 |