| NPI | 1972680577 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | MARK ALLEN ROLAIN President 586-884-5160 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207W00000X Ophthalmology (Licence: MI 4301058346) |
| Additional Taxonomies | 152W00000X Optometrist (Licence: MI 4901003679) |
| 152W00000X Optometrist (Licence: MI 4901004259) | |
| Enumeration Date | 2006-11-01 |
| Last Update Date | 2020-10-30 |