| NPI | 1760668107 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JESSE J CARDELLIO Owner/ President 586-756-5060 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207W00000X Ophthalmology |
| Additional Taxonomies | 152W00000X Optometrist |
| 332H00000X Eyewear Supplier (Equipment, not the service) (Licence: MI 005215) | |
| Enumeration Date | 2008-01-16 |
| Last Update Date | 2014-01-29 |