| NPI | 1932370848 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | SUSAN K SHIRE Technician/Office Manager 269-782-3476 |
| Organization Subpart ? | No |
| Primary Taxonomy | 152W00000X Optometrist (Licence: MI 4901002313) |
| Enumeration Date | 2008-03-19 |
| Last Update Date | 2008-03-19 |