| NPI | 1679754816 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | KENDRA SUE STANTON Administrator 248-352-2806 |
| Organization Subpart ? | No |
| Primary Taxonomy | 152W00000X Optometrist (Licence: MI 4901004206) |
| Enumeration Date | 2007-11-15 |
| Last Update Date | 2007-11-15 |