| NPI | 1609132224 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JENNIFER M SORTOR Member/Manager 734-926-0390 |
| Organization Subpart ? | Yes |
| Primary Taxonomy | 152WV0400X Optometrist, Vision Therapy (Licence: MI 490104033) |
| Enumeration Date | 2012-04-09 |
| Last Update Date | 2012-04-09 |