| NPI | 1467704759 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | AMY SOKOL Billing Supervisor 248-254-8140 |
| Organization Subpart ? | No |
| Primary Taxonomy | 152WP0200X Optometrist, Pediatrics (Licence: MI 4901003317) |
| Enumeration Date | 2012-10-10 |
| Last Update Date | 2019-04-11 |