| NPI | 1578833836 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | KENNETH JOHN KANE Certified O PT Ician/Owner 517-780-9073 |
| Organization Subpart ? | No |
| Primary Taxonomy | 332H00000X Eyewear Supplier (Licence: MI 5100005993800044100) |
| Enumeration Date | 2012-01-04 |
| Last Update Date | 2012-01-04 |