| NPI | 1467479212 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | THOMAS P. REYBURN Owner Since 1977 616-676-1283 |
| Organization Subpart ? | No |
| Primary Taxonomy | 152W00000X Optometrist (Licence: MI 4901002630) |
| Enumeration Date | 2006-07-17 |
| Last Update Date | 2023-07-14 |