| NPI | 1477738961 |
|---|---|
| Doing Business As | BEAVERTON FAMILY EYECARE |
| Entity Type | Organization |
| Authorized Contact | DALE JAMES MOSER Owner 989-386-2020 |
| Organization Subpart ? | Yes |
| Primary Taxonomy | 152W00000X Optometrist (Licence: MI 4901003085) |
| Additional Taxonomies | 332H00000X Eyewear Supplier (Equipment, not the service) (Licence: MI 003085) |
| 332H00000X Eyewear Supplier (Equipment, not the service) (Licence: MI 004640) | |
| Enumeration Date | 2008-01-03 |
| Last Update Date | 2012-04-03 |