| NPI | 1922472505 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | MONICA JOHNSONBAUGH President/Optometrist 313-473-9339 |
| Organization Subpart ? | No |
| Primary Taxonomy | 152W00000X Optometrist (Licence: MI 4901004540) |
| Enumeration Date | 2015-11-19 |
| Last Update Date | 2020-10-14 |