| NPI | 1649535808 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | CAROL L DOLAN Practice Manager 231-775-1248 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207W00000X Ophthalmology (Licence: MI RB054351) |
| Additional Taxonomies | 332H00000X Eyewear Supplier (Equipment, not the service) (Licence: MI RB054351) |
| Enumeration Date | 2012-07-12 |
| Last Update Date | 2012-07-12 |