| NPI | 1922403799 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | LISA GALONSKA Vice President 989-759-6464 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QF0400X Clinic/Center, Federally Qualified Health Center (FQHC) |
| Additional Taxonomies | 152W00000X Optometrist |
| Enumeration Date | 2014-10-23 |
| Last Update Date | 2022-04-12 |