| NPI | 1831174879 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | RICHARD MICHAEL BRENZ President 231-775-1248 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207W00000X Ophthalmology |
| Additional Taxonomies | 332H00000X Eyewear Supplier (Equipment, not the service) |
| Enumeration Date | 2005-12-13 |
| Last Update Date | 2010-04-22 |