| NPI | 1801072608 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | EDWIN RUSSELL WALLINGTON Optometrist 810-667-4777 |
| Organization Subpart ? | No |
| Primary Taxonomy | 332B00000X Durable Medical Equipment & Medical Supplies (Licence: MI 4901003847) |
| Enumeration Date | 2008-01-11 |
| Last Update Date | 2008-01-11 |