| NPI | 1942385265 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | ELIZABETH FURTAW Billing Specialist 231-722-3556 |
| Organization Subpart ? | No |
| Primary Taxonomy | 152W00000X Optometrist (Licence: MI 4901002694) |
| Enumeration Date | 2006-10-26 |
| Last Update Date | 2015-02-19 |