| NPI | 1922069806 |
|---|---|
| Former Legal Business Name | PEDIATRIC OPHTHALMOLOGY ASSOCIATE |
| Entity Type | Organization |
| Authorized Contact | JOHN ROARTY President 313-561-1777 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207W00000X Ophthalmology |
| Additional Taxonomies | 207WX0110X Ophthalmology, Pediatric Ophthalmology and Strabismus Specialist |
| Enumeration Date | 2006-03-30 |
| Last Update Date | 2020-04-20 |