| NPI | 1518029909 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | TIMOTHY B. HANLEY Owner 231-929-3888 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207W00000X Ophthalmology (Licence: MI 4301048021) |
| Additional Taxonomies | 332B00000X Durable Medical Equipment & Medical Supplies (Licence: MI 4301048021) |
| 152W00000X Optometrist (Licence: MI 4901003094) | |
| 152W00000X Optometrist (Licence: MI 4901003086) | |
| 152W00000X Optometrist (Licence: MI 4901004107) | |
| Enumeration Date | 2006-12-14 |
| Last Update Date | 2015-05-11 |