| NPI | 1902968837 |
|---|---|
| Other Name | ROSEDALE EYECARE LLC |
| Entity Type | Organization |
| Authorized Contact | DERRICK RAY MARTIN VP 313-533-4003 |
| Organization Subpart ? | No |
| Primary Taxonomy | 152W00000X Optometrist |
| Additional Taxonomies | 332H00000X Eyewear Supplier (Equipment, not the service) (Licence: MI 4901002131) |
| Enumeration Date | 2006-12-15 |
| Last Update Date | 2020-08-22 |