| NPI | 1548455561 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | GARY M MOSS Optometrist/ Owner 734-483-2100 |
| Organization Subpart ? | No |
| Primary Taxonomy | 332H00000X Eyewear Supplier (Equipment, not the service) (Licence: MI 4901002648) |
| Enumeration Date | 2007-09-12 |
| Last Update Date | 2009-11-06 |