| NPI | 1922428887 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | GAIL ELIAS VP 248-577-3624 |
| Organization Subpart ? | No |
| Primary Taxonomy | 152W00000X Optometrist |
| Additional Taxonomies | 332H00000X Eyewear Supplier |
| Enumeration Date | 2014-04-18 |
| Last Update Date | 2018-01-22 |