| NPI | 1962735282 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | DAVID GORDON VANOTTEREN President Optometrist 734-944-4404 |
| Organization Subpart ? | No |
| Primary Taxonomy | 152W00000X Optometrist (Licence: MI 4901003594) |
| Enumeration Date | 2009-09-18 |
| Last Update Date | 2009-09-18 |